Exercise and myocarditis
Clinical data linking strenuous prolonged exercise to manifestation of myocarditis and deterioration in health have not been assessed in humans, but clinical experience clearly
10,
11]. In addition, it has been clearly shown that strenuous exercise may impair immunological competence, increasing the risk of upper respiratory tract infection [
12] and possibly myocardial involvement. This is exaggerated in extreme environmental conditions.
Clinical presentation
Athletes are different from sedentary individuals with respect to their perception of clinical symptoms (see
Box
4.1.3.2). As they have been exercising for decades and know their body extremely well at rest as well as its reaction during exercise and recovery, the perception of a mild general decline of exercise capacity or muscular strength, although expressed vaguely, can well be one of the early signs of myocardial involvement in myocarditis. These symptoms often represent a subacute state that will not be diagnosed immediately as myocarditis, as several clinical parameters, including ECG and echocardiography, may be unremarkable. In these cases athletes present with higher heart rates at rest and during comparable exercise intensities, experience muscle soreness, and reduced general ‘drive’. In these conditions diagnosis of mild forms of perimyocarditis or myocarditis is difficult, particularly as symptoms include only reduced exercise performance and body discomfort, sometimes accompanied by mild depressive symptoms, which are also characteristic of an ‘overtraining syndrome’ whose cause is still unresolved but also includes viral pathogens. In all these cases myocarditis should be suspected and be at the top of a clinical work-up list for athletes.
https://oxfordmedicine.com/view/10.1093/med/9780198779742.001.0001/med-9780198779742-chapter-23
Some power athletes like wrestlers have enlarged hearts. My brother was one... he failed quite a few heart tests when he was younger but he was in tremendous shape when he was younger.
https://health.clevelandclinic.org/athletes-and-enlarged-hearts/
Something similar happens with your heart, which is also a muscle. Regular cardiovascular exercise makes your heart more efficient at pumping blood to your body. In the case of athletes who do a lot of very
high-intensity training, the heart sometimes actually gets a little bigger.
The term “athlete’s heart” refers to a natural, subtle enlargement that can happen as the heart adapts to intense athletic training. By itself, it’s not a disease or a medical condition and doesn’t cause harm.
However, an enlarged heart can also be a symptom of potentially serious heart problems such as
hypertrophic cardiomyopathy,
dilated cardiomyopathy or
hypertension.
So when a serious athlete shows sign of an enlarged heart, it’s important for a physician to differentiate between athlete’s heart and a problem, say Co-Directors of Sports Cardiology
Tamanna Singh, MD, and
Michael Emery, MD. Sometimes it takes a sports cardiology expert to tell the difference.
