Chimenti Cristina, Pieroni Maurizio, Frustaci Andrea
Department of Heart and Great Vessels Attilio Reale, La Sapienza University, Rome, Italy.
J Cardiovasc Med (Hagerstown). 2006 Apr;7(4):301-6. doi: 10.2459/01.JCM.0000219325.50622.93.
Myocarditis should be suspected in athletes with unexplained cardiac arrhythmias and dysfunction, especially if preceded by a flu-like syndrome. An early diagnosis is desirable in order to avoid the risk of fatal consequences, since physical activity can enhance the inflammatory process. Although several diagnostic tools can be useful for the diagnosis of myocarditis, endomyocardial biopsy is still the gold standard. Athletes with myocarditis should be withdrawn from all competitive sports for at least 6 months and resume training when ventricular function and cardiac dimensions return to normal and the clinically relevant arrhythmias disappear. In the presence of life-threatening arrhythmias or rapidly progressive cardiac dysfunction an antiviral or an immunosuppressive treatment should be considered depending on whether a viral agent is present or absent, respectively, in the myocardium.
对于出现不明原因心律失常和功能障碍的运动员，尤其是在出现类似流感综合征之后，应怀疑患有心肌炎。由于体育活动会加重炎症过程，因此尽早诊断以避免致命后果的风险是很有必要的。虽然有几种诊断工具对心肌炎的诊断可能有用，但心内膜心肌活检仍是金标准。患有心肌炎的运动员应至少6个月内停止所有竞技运动，当心室功能和心脏大小恢复正常且临床相关心律失常消失时，再恢复训练。对于存在危及生命的心律失常或快速进展的心脏功能障碍的情况，应根据心肌中是否存在病毒病原体，分别考虑抗病毒或免疫抑制治疗。
