Abstract
In athletes who present to their team physician with complaints of chest pain, the diagnosis of pericarditis should be entertained. Although generally self-limited, potential complications include cardiac tamponade and recurrent pericarditis. The typical scenario is of an athlete who had a recent viral upper respiratory illness and now presents with chest pain, friction rub, and characteristic electrocardiographic changes. Additional recommended testing includes complete blood count, erythrocyte sedimentation rate and/or C-reactive protein, cardiac enzymes, chest radiographs, and echocardiogram with Doppler. During acute pericarditis, participation in athletics is contraindicated. Return to play is permissible after there is no longer evidence of active disease. This is confirmed by the absence of effusion on echocardiography and normalization of serum markers of infiammation.
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References and Recommended Reading
Spodick D: Pericardial diseases. In Heart Disease: A Textbook of Cardiovascular Medicine, edn 6. Edited by Brauwald E, Zipes D, Libby P. Philadelphia: WB Saunders;2001:1823–1876.
Friman G, Fohlman J: The epidemiology of viral heart disease. Scand J Infect Dis 1993, 88(Suppl):7–10.
Launbjerg J, Fruergaard P, Hesse B: Long term risk of death, cardiac events and recurrent chest pain in patient with acute chest pain of different origin. Cardiology 1996, 87:60–66.
Braunwald E: Pericardial disease. In Harrison’s Principles of Internal Medicine, edn 16. Edited by Kasper D, Braunwald E,Fauci A, et al. New York: McGraw-Hill Professional; 2004.Good review of pathophysiology of pericarditis.
Goyle KK, Walling AD: Diagnosing pericarditis. Am Fam Physician 2002, 66:1695–1704.Excellent concise review of diagnosis and medical management of pericarditis.
Troughton R, Asher C, Klein A: Pericarditis. Lancet 2004, 363:717–727.
Lange R, Hillis D: Acute pericarditis. N Engl J Med 2004, 351:2195–2202.
Spodick D: Acute pericarditis: current concepts and practice. JAMA 2003, 289:1150–1153.
Brennan FH, Stenzler B, Oriscello R: Diagnosis and management of myocarditis in athletes. Curr Sports Med Rep 2003, 2:65–71.Review of myocarditis (a condition that may coexist with pericarditis) and the implications of myocarditis in the athlete.
Perron AD: Chest pain in athletes. Clin Sports Med 2003, 22:37–50.
Estes NAM, Link MS, Homoud M, Wang PJ: ECG findings in active patients: differentiating the benign from the serious. Physician Sportsmed 2001, 29:67–74.Concise summary of ECG findings in athletes, both normal and worrisome.
Nishimura R, Kidd KR: Recognition and management of patients with pericardial disease. In Primary Cardiology,edn 2. Edited by Brauwald E, Goldman L. Philadelphia: WB Saunders; 2003:625–642.
Huston T, Puffer J, Rodney W: The athletic heart syndrome. N Engl J Med 1985, 313:24–32.
Holly R, Shaffrath J, Amerstdam E: Electrocardiographic alterations associated with the hearts of athletes. Sports Med 1998, 25:139–148.
Bjornstad H, Storstein L, Dyre Meen H, Hals O: Electrocardiographic findings of left, right, and septal hypertrophy in athleteic students and sedentary controls. Cardiology 1993, 82:56–65.
Kane SF, Oriscello RG, Wenzel RB: Electrocardiographic findings in sports medicine: normal variants and the ones that should not be missed. Curr Sports Med Rep 2005, 4:68–75.
Maisch B, Ristic A: Practical aspects of the management of pericardial disease. Heart 2003, 89:1096–1103.
Maron B, Ackerman M, Nishimura R, et al.: 36th Bethesda Conference: eligibility recommendations for competitive athletes with cardiovascular abnormalities. Task Force 4: HCM, other cardiomyopathies, and Marfan syndrome. J Am Coll Cardiol 2005, 45:1340–1345.The recently updated authority in sports medicine on return to play decisions for athletes with cardiac conditions.
Rich BSE, Havens SA: The athletic heart syndrome. Curr Sports Med Rep 2004, 3:84–88.Excellent review of athletic heart syndrome.
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Seidenberg, P.H., Haynes, J. Pericarditis: Diagnosis, management, and return to play. Curr Sports Med Rep 5, 74–79 (2006). https://doi.org/10.1007/s11932-006-0034-z
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DOI: https://doi.org/10.1007/s11932-006-0034-z