Should physical activity be reduced after a diagnosis of acute myocarditis? – breaking latest news

After the third dose of the Covid vaccine I was diagnosed with acute myocarditis in November 2021. In September 2022 I resumed playing sports, after an MRI that showed left ventricular hypokinesia with an ejection fraction of 54%. Now I go to the gym 3/4 times a week and occasionally play soccer. I did the tests again: everything was normal, except for the left ventricular hypokinesia (with an ejection fraction of 53%). Should I reduce physical activity, since the ejection fraction is lowered?

He answers Peter Palermo, head of the Rehabilitative Cardiology Unit, Centro card. Monzino, Milan (GO TO THE FORUM)

Myocarditis an inflammatory process of the heart muscle tissue, usually caused by a viral infection and very rarely by vaccination (affecting 0.1% of vaccinated people according to a report by the FDA on 620,000 reports of adverse reactions). The inflammatory condition makes the myocardial tissue less efficient in terms of contractility (hypokinesia and reduction of the ejection fraction) and more subject to electrical alterations which could lead to the development of arrhythmias, sometimes complex. In the phases of acute myocarditis it is necessary to suspend any type of stressful stimulus at the cardiac level. You have not written with what methods the diagnosis of myocarditis was made, generally the main tests are cardiac ultrasound (which defines the possible presence of hypokinesia of the left ventricle and measures the ejection fraction), but even more cardiac magnetic resonancewhich best defines the structure of myocardial tissue.

Myocarditis is associated with any electrocardiographic abnormalities and evidence of impaired blood pressure inflammatory indices to blood chemistry controls. Once the diagnosis of myocarditis has been made, it is necessary to set up therapy aimed at reducing cardiac work and the patient is advised to lead a lifestyle free from psychophysical stress. Important will be set an instrumental follow-up programme, in order to evaluate the eventual resolution of the myocardial inflammation (control magnetic resonance at 6 months). It will be precisely the follow-up program and the outcome of the control tests that will guide the possible prescription of physical exercise. Returning to your question, you resumed playing sports about 12 months after the diagnosis of myocarditis and had no problems. Moderate physical activity of an isotonic type can continue (not indicated isometric exercise, such as lifting weights), but it would be better to confirm your improved heart condition with a follow-up MRI a 6-12 mesi.