returning to strength training, soccer after myocarditis

Hi there, long time listener first time caller. :slight_smile:
28 y/o, male, 155lbs.

After having some kind of virus (2 weeks ago), I was hospitalized a week ago with chest pain. After 48 hours in an overcrowded San Francisco ER, I was diagnosed with myocarditis (or perhaps myopericarditis). Seems like the diagnoses was solely based on elevated Troponin levels. (peaking at 46 ug/L).
every EKG looked normal, Chest Xray and a CT with contrast were fine and an echocardiogram showed a heart working totally correctly. Blood cultures and a virus panel were all negative.
Troponin was consistently decreasing and I was discharged.

I don’t think I had any symptoms of heart failure or anything else.

Cardiologist told me to titrate up exercise after symptoms resolve, and he expected symptoms to resolve within the week. after leaving the hospital, I had no other significant bouts of chest pain. I might feel something if I breathe in deep, but nothing significant.

for the next month, he gave me a beta blocker (metoprolol extended release 25mg) and an 81mg aspirin
he asked me to discontinue: adderall 5mg 2x a day (ADHD) for that month.

The Cardiologist described my levels as “the levels of a medium to large heart attack, if you were a 60 year old”, but he generally thinks I’m going to be fine—but now I’m concerned about scarring.
After getting discharged, my Card did decide to bring me back this week for a Cardiac MRI to look for any scarring.

I’m planning on returning to training (I do something between Starting strength and bridge), cutting back weight maybe 30%.

I’m not planning on trying cardio until after the MRI, and intend to take that more slowly, starting with LISS and then a jog, and then hopefully in a month or two return to playing soccer.

  • does this sound like a reasonable plan? am I moving too quickly?

  • IIUC my troponin peaked unusually high. Do you imagine theres any data linking that level to outcomes?

Hey Joe,

Your course of action is probably better off handled as a consult, though it sounds like your doc is on top of it. I would 10/10 recommend against SS for the reasons detailed here.

Regarding troponin, it’s relatively non-specific in the case of suspected myocarditis in that even if the levels are normal, that does not exclude myocarditis. Elevated troponin levels can be useful in diagnosis, but the magnitude of elevation is not necessarily correlated with anything in this context (in the acute setting). However, if they’re elevated for a prolonged time however, that can signal something else is going on, e.g. arrhythmia, a problem with the test itself due to antibodies, etc.

-Jordan