Myocarditis in athletes

  My name is Steve and I'm 16 years old.  In January of 98 I was diagnosed with cardiomyopathy, I was wrestling and during the match I was extremly fatigued.  When I came off the mat I collapsed. After 15 minutes I was fine.  The next day I went to the doctor and he sent me to a cardiologist who diagnosed me with cardiomyopathy. Along with that I had damaged my heart when I wrestled with it in the weakened state. I was through playing sports until that May when he told me that I could play football that summer, but my parents wanted a second opinion. So that July I went to a specialist in Pittsburgh (Dr. David Rosenbloom). Here I was diagnosed  with myocarditis.  The doctor said I was very lucky because my heart was normal but I couldn't play any sports or do any heavy lifting for one full year.  Since sports are a large part of my life and since my heart was normal I felt this was over doing it on the restrictions.  I would like to participate in sports my senior year but I don't think I'll be ready with these continued restrictions because my last appointment is one week before football starts.  Could someone help me understand why I have the continued restrictions if my heart is back to normal.  I would appreciate any and all responses.

[Cleveland Clinic, MD]

Dear Steve,
Thank you for your honest questions and sharing your concerns.  I agree with Dr. Rosenbloom although it may be difficult for you to accept.  Myocarditis is a viral infection of the heart muscle.  It may lead to a cardiomyopathy - a "weakness" of the heart muscle.  In your case the cardiomyopathy has apparently resolved and the muscle returned to normal.  There is still however a small risk of sudden death during strenuous sporting events.  For this reason it is not unreasonable to take a full year off.  Use the time to prepare for sports mentally and also for your school studies.  In the long run your education and your life are worth much, much more than playing a season of sports.  Good luck.  I have included some additional information and other patient questions about myocarditis below.  Not all of it will apply to you.
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Symptoms are shortness of breath, swelling in the legs, chest discomfort and palpitations and increased fatigue.  Treatment is usually medical and in severe cases heart transplant.  About a third of patients get worse with some going on to transplant.  Another third stay the same and are managed well with medical therapy and the rest get better.  Even if the heart muscle is completely "healed" a person may still feel tired due to deconditioning that occurs during the illness.  It is possible to regain your prior fitness level over time.
Q: How common is Dialated Cardiomyopathy as a result of a virus?
A:  In young people it is probably the number one cause of cardiomyopathy.  In older people it is less common.
Q: Is it serious or no big deal?
A:  It is a serious condition and should be followed carefully.
Q: Should those of us that have it be concerned?
A: Concerned in regard to taking good care of yourself and following your doctor's advice.
A: How often should one (someone with cardiomyopathy)  have their EF checked?
Q: This will vary from doctor to doctor but generally every 6 months to a year.
Q: Does the EF% have anything to do with a person's energy level?
A: Someone with a decreased EF may feel more fatigued.
Q: What is the average life years expectancy of a person with Dialated Cardiomyopathy?
A: This will vary considerably depending upon the severity of the illness.  Some people may die within months to years and others  go on to have normal lifespans.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.