Good heart health is often related to exercise, keeping blood pressure low and strengthening the heart muscle. However, exercise can actually harm a heart affected by myocarditis. This puts athletes and young people at very high risk, making myocarditis the 3rd leading cause of sudden cardiac death in young adults. One question that is frequently asked is: “When will it be safe to resume exercise after a myocarditis diagnosis?” 

Why Does Exercise Negatively Affect Myocarditis?

When you are sick and fighting an infection, your immune system will already be stressed. If you add the stress of prolonged vigorous exercise, you might quite simply overload yourself, and this may make you sicker.

Myocarditis causes inflammation of the heart muscle , and this inflammation remains for a period of time after the infection has left the body. Similar to external injuries, heart inflammation can cause scarring of the area of the heart that was affected. While scars on the heart may decrease in size as the body heals over time, there is likely to always be some scarring remaining. 

As your heart recovers, the inflammation/swelling from the myocarditis injury will subside, but the area will remain irritable for a period of time. During this time, rest is the only recommended course of action, as strenuous physical activity can further increase inflammatory response causing further damage to the heart. Scarring in the heart can affect the heart’s conduction tissue, and can cause arrhythmias and other heart complications, including dilated cardiomyopathy. 

How Soon Can I Exercise After Myocarditis?

Cardiologists typically recommend a resting period of three to six months after viral myocarditis to allow the heart tissue to heal without intense physical exercise. In a study by the Journal of Cardiovascular Translational Research, patients with no arrhythmias or ejection fraction abnormalities found after a 48-hour ECG, resumed physical exercise after three months, and were checked again for heart function at six months and twelve months after the original diagnosis. They had a low risk of cardiac event on their checkups and lessening heart damage markers. This prospective pilot study recommended that three months is the minimum amount of time to recover and begin exercise again for myocarditis patients with normal 48-hour ECGs. 

It is recommended that athletes and others who tend to keep up a more intense level of exercise wait closer to six months to begin putting stress on the heart again. This is up to the cardiologist caring for the person and very individualized.

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