what it is and what needs to be done

Curated by Davide Amato

First Covid, now myocarditis: Alphonso Davies, Bayern Munich full-back, is back in the pits. This was announced in recent days by the coach of the German team, Julian Nagelsmann: “In the follow-up examination we do with each player who has been infected with Coronavirus, we found signs of mild myocarditis – he said – . Davies will have to sit still until further notice and will not be available in the coming weeks. Now he just has to think about getting well ”. To better understand the pathology that hit the 21-year-old Canadian, we turned to Dr. Dante Mazzoleni, specialist in cardiology and sports medicine (at the “Don Orione” Center in Bergamo). And among the founders of “Cuore Batti Cuore” (https://www.cuorebatticuore.net), a voluntary association that aims to reduce the human and social damage of cardiovascular diseases.

Doctor Mazzoleni, what is myocarditis? –

“It is an inflammation of the myocardium, which is the heart muscle. The virus, once contracted, goes to all parts of the body. And when it enters the heart muscle, it inflames it, making it pump less ”.

How serious is this pathology? –

“You can also die of myocarditis: if the inflammation is strong, the heart cannot pump. Much more often, and we have seen it with Covid, the interest is modest. There is a decrease in the efficiency of the heart muscle and blood pumping – the whole body suffers. For example, you are tired or short of breath. Myocarditis weakens and therefore limits athletic performance “.

The cause? —

“We have known myocarditis for a long time. It has always been difficult to say what they depended on. The most probable hypothesis is that of the viral origin. As in the case of these deriving from Covid. The virus is the most frequent cause “.

The incidence? –

“Once, in the hospital, we saw three myocarditis a year. It was a rare condition. Now, with the Covid-19 pandemic, there are many. Many are very light, but still need to be treated with caution to avoid complications. Although myocarditis is infrequent, with so many virus positives the incidence has risen ”.

The impact of myocarditis on a professional? –

“Most of the time it is light, as in Davies’ case: in a few weeks it resolves and you can start playing again. The current protocol provides, for athletes who have had Covid, a series of steps before returning to the field: you have to be negative and take two exams. The maximal effort test and Doppler ultrasound (echocardiogram). The latter helps to understand the extent of myocarditis, because it allows you to see the contraction of the heart. If it is reduced by half, for example, the situation is serious. But even if the contraction is slightly below the threshold, we must still be cautious ”.

How should one behave? –

“Once recovered from Covid, if the tests are normal, the professional can resume playing, but if the exams show an impairment, even modest, then he must sit still until it goes right. With the Omicron variant it has been seen that myocarditis is resolved in most cases. But you have to be sure. And stay under the orders of cardiologists until it disappears. Otherwise, if you make an important effort, you could even risk cardiac arrest. Of Eriksen’s illness in the European Championship, for example, there is no certainty, but it could also have been myocarditis ”.

Is there a cure for myocarditis? –

“There is no specific therapy for myocarditis. Medicines are used, such as beta blockers or ACE inhibitors, which help the heart pump even if it is sick. Myocarditis usually heals on its own. Sometimes, however, it can leave consequences. And if these are important, they can also turn into heart failure “.

January 18, 2022 (change January 18, 2022 | 08:45)

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