Myocarditis and Dilated Cardiomyopathy in Athletes: Diagnosis, Management, and Recommendations for Sport Activity
Section snippets
Dilated cardiomyopathy
DCM is a heart muscle disease characterized by left ventricular dilatation and systolic dysfunction with normal left ventricular wall thickness [9]. The estimated prevalence of DCM is 1 case per 2500 population, and it is the third most common cause of heart failure and one of the major diseases requiring cardiac transplantation. DCM is a heterogeneous disease with a multifactorial pathogenesis [2], [10]. It may be familial/genetic, viral, or immune related, which explains why it has been
Myocarditis and dilated cardiomyopathy as causes of sudden death in young athletes
Myocarditis has been traditionally considered an important cause of sudden death in young individuals including athletes, although its importance may be exaggerated because of overinterpretation of histologic data and the lack of standardized morphologic criteria (Fig. 1). It has been shown that intense physical exercise, either as a single episode of exhausting exercise or as persistent overtraining, can increase the susceptibility to upper respiratory infections as a consequence of a
Recommendations for sport activity in athletes affected by myocarditis and dilated cardiomyopathy
The recommendations for sport activity discussed herein are based on recent consensus documents of expert panels of the European Society of Cardiology and the Sports Cardiology Section of the European Association of Cardiovascular Prevention and Rehabilitation [31], [32].
Myocarditis may evolve into a chronic inflammation, often with a subclinical course, and eventually progress into DCM (Fig. 3). It is of utmost importance to respect an adequate period of athletic rest until the disease has
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Is Exercise Helpful or Harmful in Dealing With Specific Arrhythmia
2021, Current Problems in CardiologyApplication of Multiparametric Quantitative Cardiac Magnetic Resonance for Detection and Monitoring of Myocardial Injury in Patients with Fulminant Myocarditis
2021, Academic RadiologyCitation Excerpt :Active inflammatory edema is mainly observed in the acute stage and usually resolves quickly during the healing process of myocarditis. Accurate detection and monitoring of the inflammatory myocardial alterations is essential for clinical decision-making (9,10). Endomyocardial biopsy (EMB) can directly assess myocarditis injury, but was rarely performed due to its invasive nature and possible sampling errors (11).
Should we fear infarct-like myocarditis?
2018, Cor et VasaCitation Excerpt :According to the European Society of Cardiology (ESC) recommendations, published in their Position Statement [5], prohibition of physical activity is recommended. However the recommendation is based on the work of Basso et al. [16] and Pelliccia et al. [17], who were making recommendations for athletes. Athletes were allowed to continue sports activity 6 months after disease appearance, depending on follow-up examination results.
Approximation of the Incidence of Myocarditis by Systematic Screening With Cardiac Magnetic Resonance Imaging
2018, JACC: Heart FailureCitation Excerpt :Up to this point, numerous studies evaluated the incidence of myocarditis based on CMR data. However, due to discrepancy in the results and a lack of a shared standardized diagnostic approach the true incidence of myocarditis has remained uncertain (5,8,9,11,14–16). In that regard Pitts et al. (1) and Karjalainen and Heikkilä (9) showed that clinically diagnosed myocarditis in young men was present in 99 patients of 672,672 Finnish military conscripts over a period of 20 years with an incidence rate of 0.17 per 1,000 man-years.
Sudden Cardiac Death in Athletes
2018, JACC: Heart FailureCitation Excerpt :Primary, inherited electrical cardiac abnormalities were implicated in ≤5% of confirmed SCD events in the U.S. Registry (8) and <4% in NCAA athletes (6,7), and 0% were identified in studies from the United Kingdom (36) and Australia and New Zealand (37). Acquired abnormalities such as commotio cordis, which is increasingly reported in the United States and worldwide (38,39); myocarditis, which may have multiple causes (40); and environmental factors and performance-enhancing drugs have been linked with SCD in athletes (41,42). Anomalous coronary artery origins, particularly a coronary artery originating from the wrong aortic sinus, is a frequent cause of SCD, ranging from 7% to 17% of athlete cases (8,36,43).
Organ-Specific Autoimmune Myocardial Diseases: From Pathogenesis to Diagnosis and Management
2017, The Heart in Rheumatic, Autoimmune and Inflammatory Diseases: Pathophysiology, Clinical Aspects and Therapeutic Approaches
This work was supported by the Veneto Region, Venice, Italy; Cariparo Foundation, Pedove, Italy; Ministry of Health, Rome, Italy.