Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy.
J Cardiovasc Transl Res. 2020 Jun;13(3):284-295. doi: 10.1007/s12265-020-09996-1. Epub 2020 Apr 8.
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.
心肌炎是运动员心源性猝死（SCD）的一个重要原因。尽管意大利在开展运动前筛查后，SCD 归因于心肌炎的发生率并未改变，但这是由于疾病的一过性和与运动员心脏的鉴别诊断问题所致。心律失常负担和潜在机制在急性和慢性期有所不同，这取决于急性炎症与炎症后心肌纤维化的相对影响。在急性期，室性心律失常从孤立性室性期前收缩到可导致 SCD 的复杂心动过速不等。房室传导阻滞是特定类型心肌炎的典型表现，而当发生心房炎症时可能出现室上性心律失常。急性心肌炎患者应暂时限制体力活动，直至完全恢复。然而，在炎症后心肌瘢痕的情况下，慢性期也可能发生室性心动过速。
