2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease
We have completed guidelines recommended for an “Exercise recommendations in individuals with aortopathy and cardiomyopathies” in the month of January. While moving forward in this 2020 ESC guidelines, we are going to summarize guidelines for “Exercise recommendations in individuals with myocarditis and pericarditis” this month.
The author Antonio Pelliccia, Sanjay Sharma and other members of the European Society of Cardiology (2020) have come up with exercise recommendation in different types of cardiac problems.
Objective:
To provide safe and evidence-based exercise programs for a patient with myocarditis and pericarditis.
Method:
The guideline was developed from the currently available evidence and scientific and medical knowledge. The selected articles were later classified and graded depending on the usefulness/ efficacy of the procedure and methodology of clinical trials.
Recommended guidelines:
Recommendations for exercise in individuals with myocarditis:
• A comprehensive evaluation, using exercise stress test, imaging studies, and Holter monitoring, is recommended after recovery from acute myocarditis to assess the risk of exercise-related sudden cardiac death (SCD).
• In asymptomatic individuals, return to all forms of exercise including competitive sports should be considered after 36 months, with normal LV systolic function on echocardiography and CMR, normal troponin and biomarkers of inflammation, good functional capacity, no evidence of myocardial fibrosis, or ongoing inflammation on CMR, and absence of frequent and/or complex VAs on ambulatory Holter monitoring or exercise testing.
• Among individuals with a probable or definitive diagnosis of recent myocarditis, it is not recommended to participate in leisure-time or competitive sports while active inflammation is present.
• It is not recommended to participate in moderate- to high-intensity exercise for a period of 36 months after acute myocarditis.
• Participation in high-intensity leisure exercise or competitive sports in individuals with a residual myocardial scar and persistent LV dysfunction is not recommended.
Recommendations for exercise in individuals with pericarditis:
• For individuals who have recovered completely from acute pericarditis, depending on clinical severity; return to all forms of exercise including competitive sports is recommended after 30 days to 3 months.
• Participation in leisure-time or competitive sports is not recommended for individuals with a probable or definitive diagnosis of recent pericarditis while active inflammation is present, regardless of sex, age, or extent of LV systolic dysfunction.
• For individuals with constrictive pericarditis, participation in moderate- to high-intensity exercise, including competitive sports, is not recommended.
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