Myocarditis in the Athlete: Arrhythmogenic Substrates, Clinical Manifestations, Management, and Eligibility Decisions

被引:17
作者
Vio, Riccardo [1 ]
Zorzi, Alessandro [1 ]
Corrado, Domenico [1 ]
机构
[1] Univ Padua, Dept Cardiac Thorac Vasc Sci & Publ Hlth, Via Giustiniani 2, I-35128 Padua, Italy
关键词
Myocarditis; Athletes; Sport; Ventricular tachycardia; Ventricular fibrillation; Atrial fibrillation; Atrioventricular block; Sudden death; CARDIAC MAGNETIC-RESONANCE; RIGHT-VENTRICULAR DYSFUNCTION; AMERICAN-HEART-ASSOCIATION; CARDIOLOGY WORKING GROUP; GIANT-CELL MYOCARDITIS; T-WAVE INVERSION; EUROPEAN-SOCIETY; HYPERTROPHIC CARDIOMYOPATHY; PROGNOSTIC RELEVANCE; ATRIAL-FIBRILLATION;
D O I
10.1007/s12265-020-09996-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Myocarditis is as an important cause of sudden cardiac death (SCD) among athletes. The incidence of SCD ascribed to myocarditis did not change after the introduction of pre-participation screening in Italy, due to the transient nature of the disease and problems in the differential diagnosis with the athlete's heart. The arrhythmic burden and the underlying mechanisms differ between the acute and chronic setting, depending on the relative impact of acute inflammation versus post-inflammatory myocardial fibrosis. In the acute phase, ventricular arrhythmias vary from isolated ventricular ectopic beats to complex tachycardias that can lead to SCD. Atrioventricular blocks are typical of specific forms of myocarditis, and supraventricular arrhythmias may be observed in case of atrial inflammation. Athletes with acute myocarditis should be temporarily restricted from physical exercise, until complete recovery. However, ventricular tachycardia may also occur in the chronic phase in the context of post-inflammatory myocardial scar.
引用
收藏
页码:284 / 295
页数:12
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