Abdelfattah Omar M, Mathur Tarun, Martinez Matthew W
Department of Medicine, Morristown Medical Center, Atlantic Health System, 100 Madison Avenue, Morristown, NJ 07960, USA.
Department of Cardiology, Bryn Mawr Medical Specialists Association, 825 Old Lancaster Rd, Bryn Mawr, PA 19010, USA.
Eur Heart J Case Rep. 2023 Jan 27;7(2):ytad038. doi: 10.1093/ehjcr/ytad038. eCollection 2023 Feb.
Post-viral myocarditis has been associated with sudden cardiac death in athletes. Since the beginning of the COVID-19 pandemic, the concern of post-viral myocarditis impacting the professional athletic community has been present.
An elite-level basketball player presented after a positive COVID-19 test with findings consistent with ventricular tachycardia related to myocardial fibrosis/scar from a COVID-19-related myocarditis. Although rare, COVID-19 myocarditis can occur. This case illustrates how the consensus guidelines for return-to-play correctly identified the player as high risk with appropriate downstream evaluation by cardiac magnetic resonance (CMR) imaging. The stepwise approach is illustrated in this case and highlights the utility and success of the algorithm when approaching athletes with COVID-19-related myocarditis risk and determining a return to exercise.
Diligence is required to identify competitive athletes with features suggestive of myocarditis at the initial presentation and with the return to exercise. Cardiopulmonary symptoms in the setting of recent COVID-19 infection should prompt additional testing in a stepwise fashion and often benefit from CMR in addition to the triad testing with electrocardiography, echocardiography, and cardiac troponin measurement to further investigate clinical presentations of COVID-19-related myocarditis.
病毒性心肌炎与运动员心源性猝死有关。自新冠疫情开始以来，病毒性心肌炎影响职业运动员群体的担忧一直存在。
一名精英级篮球运动员新冠病毒检测呈阳性后就诊，检查结果显示与新冠病毒相关心肌炎所致心肌纤维化/瘢痕引起的室性心动过速相符。虽然罕见，但新冠病毒心肌炎是可能发生的。本病例说明了重返赛场的共识指南如何通过心脏磁共振成像（CMR）正确地将该运动员识别为高风险，并进行适当的下游评估。本病例展示了逐步方法，并突出了该算法在处理有新冠病毒相关心肌炎风险的运动员并确定恢复运动方面的实用性和成功性。
在初次就诊和恢复运动时，需要勤勉地识别有心肌炎特征的竞技运动员。近期新冠病毒感染情况下的心肺症状应促使逐步进行额外检测，除了进行心电图、超声心动图和心肌肌钙蛋白检测的三联检测外，通常还受益于CMR，以进一步调查新冠病毒相关心肌炎的临床表现。
