Status: 09.12.2023, 09:14 a.m.
By: Marius Gogolla
Myocarditis is the third leading cause of death among young athletes. The diagnosis is difficult, so the disease often goes undetected.
Cologne – The death of the Regensburg professional Agyemang Diawusie once again brought a treacherous disease into the public eye: inflammation of the heart muscle (myocarditis) is not always associated with specific symptoms and is often difficult to recognize.
Died of sudden cardiac death as a result of myocarditis: Footballer Agyemang Diawusie from Jahn Regensburg. (Archive photo) © IMAGO/Maximilian Koch
In myocarditis, the cells of the heart muscle tissue are inflamed. If myocarditis is diagnosed, action must be taken quickly, as untreated inflammation can lead to permanent heart failure and even sudden cardiac death. In many cases, however, it remains undetected because it causes no or only mild symptoms.
Myocarditis is the third most common cause of death among young athletes
The insidious disease, which repeatedly afflicts young athletes, is "a problem and always a great challenge," Hans-Georg Predel, head of the Institute for Circulatory Research and Sports Medicine at the German Sport University Cologne, told the news agency Sport-Informations-Dienst (SID).
Myocarditis is the third most common cause of death among young athletes under the age of 35, and it is even the most common cause of sudden cardiac death in adolescents under the age of 18.
Causes of myocarditis
In most cases, inflammation of the heart muscle is caused by infections as a result of an illness, such as a cold or a gastrointestinal infection. The pathogens reach the heart via the blood from the actual site of infection. Infectious myocarditis can be caused by viruses and bacteria.
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"Most of the time, it is viruses that enter the body via the respiratory tract and are carried to the heart muscle," says Predel, explaining the development: "The heart muscles are very strongly supplied with blood so that the heart can function, and therein lies the weak point."
Causes of non-infectious myocarditis include, for example, autoimmune diseases, harmful substances such as alcohol and drugs, as well as medication and vaccinations.
FC Bayern Munich's Alphonso Davies was absent for months due to myocarditis
A prominent victim of the disease was Alphonso Davies, who was fortunately diagnosed with myocarditis early in January 2022 after a corona infection. The Canadian Bayern Munich defender was then absent for months. Strict protection is the top priority of therapy, then the disease usually heals without consequential damage.
However, if the inflammation, which is often asymptomatic, remains undetected, there is a risk of dramatic consequences. At the end of October, the 34-year-old ex-Wolfsburg player Bas Dost collapsed on the pitch during an Eredivisie match - the doctors were fighting for his life in the stadium. Dost was lucky in his misfortune, was resuscitated on the pitch and is now recovering from his myocarditis in peace.
Myocarditis is sometimes difficult to diagnose
But why can't dramatic cases like that of Dost and probably Diawusie be prevented – despite the close medical care of professional footballers? The problem is the sometimes extremely complex diagnostics, some inflammations can simply hardly be detected.
"You really can't scold the medical departments when something like this happens," says Predel - on the contrary: "The way I experience it, they are now very sensitive."
Also because competitive athletes are particularly at risk. Because where people "go to their limits and also travel a lot," says Predel, "it can happen more often that there are undetected myocarditis."
Symptoms of myocardial disease are non-specific
The possible symptoms of myocarditis can vary greatly. In many cases, there are no or very general symptoms, which makes myocarditis not easy to detect. Possible symptoms may include:
- Tiredness and fatigue
- Body aches
These symptoms often occur within a few weeks of an infection. If symptoms such as tiredness, fatigue or fever do not subside after a cold or reappear after a short time, this can be an indication of a protracted infection and a warning sign of myocarditis.
Sometimes the symptoms of myocarditis resemble an acute heart attack. Symptoms then include sudden stabbing chest pain, shortness of breath, palpitations or palpitations, as well as pale or bluish skin and lips.
Athletes should also take minor illnesses seriously
In prevention, it is crucial to take even minor illnesses seriously. "The main enemy" are the "banal infections" with mild symptoms, with which athletes simply continue to train. A mistake, as Predel warns. He advises the athletes "not to enter into peak loads, even in the case of mild infections without fever."
In addition, it is a matter of training people in the sporting environment "to be able to provide professional first aid in an emergency," says Predel, because – as was recently painfully clear in Regensburg – "there is no absolute security." (mag)