Emory Sports Cardiologist discusses athlete’s heart risks following COVID-19

On Tuesday both the PAC-12 and Big Ten conferences postponed their fall football seasons. According to a CBS report conference athletic directors received ‘eye opening’ new information that helped them reach their decision. That information surrounded heart condition known as myocarditis.

FOX 5’s Justin Felder spoke with Dr. Jonathan Kim who is the Chief of Sports Cardiology at Emory University and the team cardiologist for Emory Athletics, Georgia Tech Athletics, Atlanta Falcons, Atlanta Hawks, Atlanta Braves, and Atlanta Dream, to find out more about the condition and how COVID-19 might create a heart issue with athletes.

Myocarditis an inflammation of the heart muscle that is typically caused by viral infections. Dr. Kim says that among the early, hospitalized patients suffering from COVD-19 was a high degree of cardiac injury. Kim says it was happening more so than is typical from other respiratory illnesses.

Dr. Kim says that intense exercise for a patient with myocarditis will cause more intense inflammation and that could lead to a number of heart problems.

“We know that exercise with that intense inflammation can potentially be a risk factor for the precipitation of dangerous heart rhythms and potentially even sudden cardiac arrest or death. It is one of the more common causes of sudden cardiac death in athletes despite the fact that it is not one of the most common conditions out there in the general population,” says Dr. Kim.

Dr. Kim pointed out that there is not currently enough data to determine COVID-19’s long term effect on an athlete’s heart, but he said seeing the heart damage suffered by early, hospitalized patients has shaped how he is approaching an athlete’s return following a COVID-19 diagnosis.

“Because of what we saw among the sicker population that made us feel as a sports cardiology community that we should respect the virus and we should be at least conervative in the beginning as it relates to competitive athletes coming back to the field and return to play,” said Dr. Kim.

Dr. Kim recommends that elite athletes who suffered from COVID-19 undergo heart screenings to determine if they have myocarditis. According to Dr. Kim recommended testing by a cardiologist would include a 12-lead electrocardiogram (EKG), echocardiogram (ultrasound of heart), and blood test (troponin) looking for biochemical evidence of cardiac injury.

“If the diagnosis is made [for myocarditis] based off the symptoms picked up in an evaluation and knowing that intense exercise can make the condition worse and certainly put the athlete at risk for dangerous arrhythmias, we recommend that there is no competitive exercise for at least three months. Per guidelines it’s three to six months and that’s rest, no intense exercise. After the three month period, maybe longer, then there’s repeat risk stratification to see if all the inflammation is gone, if the heart function is normal and at that point an athlete could come back and return to play,” said Dr. Kim. 

When it comes to those who are not “elite athletes” Dr Kim said that a trip to the cardiologist is not necessarily in order. 

“I would say probably not. I would advise that there should be a slow return. Respect the disease process even if you didn’t have significant symptoms. There’s just so much we don’t know. So don’t go right back out there and get back to your routines. Take it slowly and make sure you’re not having any symptoms. For those who are engaged in really intense level of activity, your marathon runner, your triathlete, it may be reasonable to at least start the discussion with your primary care physician. If you choose to see a sports cardiologist, I don’t think there’s anything wrong with that. But I don’t think the message is that everyone with COVID-19 needs to have all of this heart testing to get back to regular activities. The message is take it slowly,” said Dr. Kim.

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