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Post-pericardiotomy Syndrome — EECC MCQ

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HardPericardial DiseasePost-pericardiotomy SyndromeEECC

A competitive cyclist had acute myocarditis with troponin elevation and non-sustained ventricular tachycardia. After the prescribed exercise-restriction period he is asymptomatic, biomarkers have normalised and resting LVEF is preserved. Which complete assessment bundle is required before high-intensity competition is reconsidered?

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Reveal the answer and explanation

Correct answer: A — Repeat cardiac imaging, ambulatory rhythm monitoring and maximal exercise testing

Return to high-intensity sport after myocarditis requires reassessment of ventricular function and residual inflammation or scar, spontaneous arrhythmia burden and exercise-provoked arrhythmia; repeat imaging, ambulatory monitoring and maximal exercise testing provide those complementary domains. Option E omits structural reassessment, option C omits both ambulatory and exercise-provoked rhythm testing, option B omits imaging and uses an inadequate submaximal study, and option D omits maximal exercise assessment.

Reference: 2025 ESC Guidelines for myocarditis and pericarditis. https://academic.oup.com/eurheartj/article/46/40/3952/8234483