Table 3.

Management of acute infectious myopericarditis in athletes (adapted from Friman et al. ⁵⁴ )

Patients with definite myopericarditis
	Observe in hospital during period of elevated serum levels of myocardial injury markers
	Treat complex dysrhythmias and heart failure
	Test for specific infections, treat bacterial infections
	After first week, avoid strenuous exercise until ECG at rest has normalized or stabilized (which occurs within 2 months in most mild to moderate cases)
	In convalescent period, beta‐blocking drugs may be considered if hyperkinetic heart symptoms are present
	Maximal exercise ECG test before resuming sport activities or other major heart‐taxing efforts
Patients with possible myopericarditis
	Avoid strenuous exercise until myopericarditis has been excluded
Common conditions often wrongly diagnosed as myocarditis
	Misinterpreted ECG, e.g. hyperadrenergic state with T‐wave changes (beta‐blockade normalizes ECG) or early repolarization pattern in ECG, both common in athletes
	Overtraining syndrome, especially when combined with findings significant to the athlete's heart
	‘Heart neurosis’ to which various symptoms and signs often contribute

ECG, electrocardiogram.