Myocarditis In Athletes


What is myocarditis?

Myocarditis means inflammation of the heart muscle called the myocardium. This inflammation can compromise heart function to the extent that it may reduce the heart’s ability to pump blood. It can be caused by being exposed to toxins, infections, or because of an autoimmune response (Nishant Shah & Dermot M. J. Phelan, 2018).

How is it diagnosed?

Myocarditis is ideally diagnosed through physical examination, ECG, and echocardiography. Particularly athletes with high susceptibility to heart disorders should be subjected to cardiac magnetic resonance. Patients with severe myocardial function impairment should be advised endomyocardial biopsy to gauge the level of damage to the heart. Also, if someone has been diagnosed with myocarditis then they should get a detailed follow-up for this condition for at least 6 months (Martin Halle, 2019).

What symptoms are associated with myocarditis?

People with initial myocarditis may not have any symptoms at all. The common symptoms include chest pain, shortness of breath when resting or during activity, arrhythmia, fatigue, swelling in feet/ankles, and light-headedness (Staff, 2022). Severe myocarditis can lead to a weakened heart with compromised heart function.

Can someone with COVID-19 infection or vaccine develop myocarditis?

Cases of myocarditis have been seen more often after receiving the second shot of the COVID-19 mRNA vaccine in adolescents and young male athletes (Myocarditis and Pericarditis After mRNA COVID-19 Vaccination, 2022). Infection with COVID-19 may also result in myocarditis.

Why is the diagnosis of myocarditis crucial in athletes?

Undiagnosed myocarditis in athletes may be a cause of sudden cardiac death (SCD) which accounts for 5-22% of fatalities in athletes. More than half the patients with myocarditis just do not know that they have a problem. It is thought that some of the complications are triggered when adrenaline is peaked during exercise (running, working, jogging, sprinting, stress) resulting sudden cardiac death. Intense exercise and physical exertion are known to trigger arrhythmia. (Gloria Modica, 2022). Finally, it should be noted that prior to COVID-19 there were approximately 79 athletes dying per year from myocarditis. That number has now skyrocketed to approximately 1376 athletes now dying per year according Dr. Peter McCullough.


References:

Gloria Modica, 1. M. (2022). Myocarditis in Athletes Recovering from COVID-19: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health , 1-12.
Martin Halle, M. S. (2019). Myocarditis in Athletes. In e. a. Antonio Pelliccia, The ESC Textbook of Sports Cardiology. Oxford: Oxford University Press.
Myocarditis and Pericarditis After mRNA COVID-19 Vaccination. (2022, September 27). Retrieved from CDC:
Nishant Shah, M. F., & Dermot M. J. Phelan, B. P. (2018, January 31). Myocarditis in the Athlete. Retrieved from American College of Cardiology:
Staff, M. C. (2022, May 20). Myocarditis. Retrieved from Mayo Clinic:




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