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Review
. 2022 Dec;43(13):1097-1105.
doi: 10.1055/a-1810-5314. Epub 2022 Mar 28.

Sports, Myocarditis and COVID-19: Diagnostics, Prevention and Return-to-play Strategies

Thomas Schmidt  1   2 , Birna Bjarnason-Wehrens  2 , Jonas Zacher  2 , Hans-Georg Predel  2 , Nils Reiss  1
Affiliations
Review

Sports, Myocarditis and COVID-19: Diagnostics, Prevention and Return-to-play Strategies

Thomas Schmidt et al. Int J Sports Med. 2022 Dec.

Abstract

Myocarditis is an umbrella term for non-ischemic myocardial inflammation and remains a leading cause of sudden cardiac death in active individuals and athletes. Accurate diagnosing is challenging and diseases could often remain undetected. In the majority of cases, acute myocarditis resolves favourably. However, a relevant proportion of patients may have an increased risk of prognostically relevant cardiac arrhythmias and/or the development and progression of maladaptive myocardial remodelling (dilated cardiomyopathy). This review provides current knowledge on myocarditis and sports with special regard to the COVID-19 pandemic. Possible causes, common symptoms and proposed diagnostics are summarized. The relevance of temporary avoidance of intensive sports activities for both the prevention and therapy of acute myocarditis is discussed. Risk stratification, specific return-to-play recommendations and proposed follow-up diagnostics (also after COVID-19 infection) are presented.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Key components of myocarditis and sports. Abbreviations: SCD, sudden cardiac death; ECG, electrocardiography; TTE, transthoracic echocardiography; CMR, cardiovascular magnetic resonance imaging.
See this image and copyright information in PMC

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