ROLE OF MYOCARDITIS IN ATHLETES WITH MINOR ARRHYTHMIAS AND OR ECHOCARDIOGRAPHIC ABNORMALITIES/

We report the clinical and instrumental data, including the endomyocar dial biopsy findings, of six young athletes presenting with minor arrh ythmias and/or echocardiographic abnormalities. In one of them, a left ventricular dilation with moderate depression of the systolic functio n had been attributed to an athlete's heart. A diagnosis of arrhythmog enic right ventricular dysplasia had been made in three others, one wi th right ventricular dilation and apical hypokinesia, and two with ven tricular arrhythmias with QRS morphology of left bundle branch block. A myocarditis could be unequivocally established in four athletes (two with and two without fibrosis). In the remaining two, with a clinical history strongly suggesting a previously acute myocarditis, the endom yocardial biopsy specimen revealed a nonspecific fibrosis compatible b ut not definitely pathognomonic of a healed myocarditis. Our report su ggests that a myocarditis may be a cause of minor rhythm disturbances and/or echocardiographic abnormalities in athletes. A prevalent locali zation of the inflammatory process in the right ventricle with or with out the occurrence of ventricular arrhythmias with left bundle branch block morphology can mimic an arrhythmogenic right ventricular dysplas ia. An early diagnosis of myocarditis in athletes is useful to avoid t he risk of fatal arrhythmias, also considering that rest still keeps o n being one of the most effective strategies in myocarditis management .