Myocarditis is defined as an inflammation of the heart muscle and its presentation, especially in athletes, is heterogeneous. Underlying causes include in most of the cases viruses, and less often bacteria, toxins, vasculitic diseases or pharmaceutical agents. Cardiac magnetic resonance (CMR) imaging is the primary imaging tool to diagnose myocarditis following laboratory test, electrocardiogram and echocardiography. In certain cases, endomyocardial biopsy is required, especially in unclear cases with reduced systolic left ventricular ejection fraction.
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Sudden death of an athlete is the most devastating medical event in sports. While accidents account for more than 50% of these cases, sudden cardiac deaths (SCD) are less frequent (approx. 15%), but the leading medical cause of deaths. The risk depends on age, sex, ethnicity, type of sport and sport level. There are large variations in the methods of registration of SCD in recreational and competitive sports. This must be taken into account when interpreting reported incidences and causes. High data quality in registries is a prerequisite for meaningful preventive strategies (e.g. ECG screening and safety at sports facilities).
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