Pericarditis - heart muscle inflammation

The heart is clearly the symbol of love and life. One comes from the other. It is a symbol of love, strength, endurance, stamina and life. (1)

The heart has a special meaning for us and is a vital organ. It is our engine and beats in us from the first to the last minute. On average, it beats 70 times per minute and pumps about 10 liters of blood through the vessels. If we take a 75-year-old, his heart beat 2, 759, 400, 000 times over the course of his life, carrying 394, 200, 000 liters of blood. This is equivalent to the amount of water in 197 large swimming pools in an outdoor pool! (2)

But what happens if the heart does not work properly? There have been many reports in recent years that "fit" people, often athletes, have died "suddenly and unexpectedly". Later one hears then that the cause of death was a heart disease.

Birgit Dressel, Heiko Fischer, St├Ęphane Morin, Florence Griffith-Joyner - these are well-known athletes names that unite this tragic fate. Some of them are the tip of the iceberg of about 900 athletes who suffer cardiac death each year in Germany. This is shockingly often young top athletes. Lack of autopsy is rarely known who died of heart muscle disease. In public, these deaths are mentioned in an unpleasant context: If a well-known athlete dies "suddenly and unexpectedly", they will first be tapped on doping. (3) This assumption may sometimes be obvious, but unfortunately this is often only a media-effective alibi for undetected illnesses.

What is a heart muscle inflammation?

Heart muscle inflammation, termed myocarditis in technical language, is understood to mean an acute or chronic inflammation of the heart muscle, which may also affect the pericardium.

The inflammation disturbs and weakens the ability of the heart to contract, leading to a loss of performance and thus to cardiac insufficiency with impaired function.

Myocarditis is the cause of a sudden death in adults before the age of 40 in about 20% of the cases. It can occur at any age, but usually heals without problems.

What symptoms are known?

There are no typical symptoms (signs) of myocarditis. The suspected diagnosis is based on rather nonspecific complaints that occur in connection with influenza infections or other feverish infectious diseases.

In advanced disease even the slightest effort can lead to severe respiratory distress. A heart muscle inflammation is usually transmitted by viruses or bacteria. Virus-acquired myocarditis is usually preceded by diarrhea or cold 2 weeks previously. It has been proven that 80% of the diseases are caused by the so-called coxsackie viruses. A development by adeno, influenza, measles or herpesviruses is possible. The bacteria that can cause myocarditis include Borrelia, as well as the causative agents of scarlet fever and diphtheria. Myocarditis is probably caused by the fact that the body's own immune system is directed against its own heart muscle.

As a rule, a heart muscle inflammation heals without consequences. However, cases are known in which those affected have died of cardiac arrhythmias or acute heart failure within a short time.

The connection between sports and myocarditis

In order to prevent heart muscle inflammation, it is important to protect yourself physically with a cold with fever. Sport should be taboo. Often, an infection that has not been fully cured leads to infection of the heart muscle by viruses and bacteria from their own blood. Sporting training despite the onset of a cold can aggravate the symptoms and lead to the so-called "carry-over" of the disease. (4)

Pericarditis

In pericarditis, the pericardium is inflamed. The pericardium surrounds the entire heart with an outer and an inner layer that rests directly against the heart muscle. If the pericardium becomes acutely inflamed, it causes severe chest pain, which is typically respiratory and postural. The cause of pericarditis remains often unclear, with experts suspect in 80- 90% of those affected a viral infection as a trigger. In addition, however, a variety of diseases come into consideration as a cause. (5) An echocardiography (ultrasound examination of the heart) shows an enlargement of the heart cavities, a limitation of the pumping function and possibly a pericardial effusion (pericardial effusion). (6)

My story October 2007 - January 2008

I am an active person and have always been very athletic. I pay attention to a healthy diet, my weight and mental health. I have been training as a fitness trainer for almost 20 years, working full-time and having 2 teenagers, a husband, home and garden. I have a great circle of friends and never boredom.

In October 2007 I taught - as every Monday - in Kronberg in a gym and wondered during my course why I already had such a high heart rate (<140) during the "warm-up" and was out of breath.

Also the course afterwards (indoor cycling) was different than usual with very high heart rate and I was very short of breath. I have not thought so much about it, because if you z. B. hatches a cold, the heart rate can always be higher.

But the symptoms remained and I could not explain it because I did not get a cold. Then I suspected I had asthma. As a kid I had 'child asthma' and thought 'well maybe that's it'. I was with my doctor to clarify this suspicion, but he could not explain it. He gave me to "try" Asthma Spray. But that did not work.

Then I briefly had the idea, perhaps to respond to the cleaning agents allergic. But on request to the studio management I was told that no new funds are in use.

After the symptoms persisted, I went to the doctor again. I should go for an ECG on the ergometer. I "quit" after a short time because I could not breathe anymore. Since my doctor knew me and knew that I was very athletic, he was extremely alarmed and sent me to cardiac MRI (Magnetic Resonance Imaging) for an appointment.

A few days later I went to Bad Nauheim in the Kerkhoff Clinic for specialists. It was my first MRI and I was really looking forward to the result. In the clinic I received the diagnosis from a very nice and competent doctor: pericarditis with pericardial effusion! It meant: Immediately from home and directly on the sofa - just rest! I did not get any meds because I was not in pain. It said: do not run around, do not shop, do nothing in the house! Control in 4 weeks!

I did not expect that; on the following day I wanted to go abroad on business and worked on a presentation in the waiting room. I was set from 100% to 0% from minute to minute. I had a very bizarre and unreal feeling, not depressing - but weird.

I do not know why, but I did not go crazy. I did not realize how sick I was and how dangerous the whole thing could be. I was like "Susi Careless". But I think that was the best reaction for me and my soul. I also did not research further on the topic. What my doctors gave me on the way was enough for me.

Patience is not my strength, it was not easy to live the day more or less haphazardly. My life and my daily routine had to change completely. Before, everything was always exactly clocked, otherwise everything would not have worked out. But over the next 10 weeks, that has changed. I adapted quickly to the new rhythm. I was suddenly "housewife and mother", my main thoughts were: "What am I cooking?" And what do I have to go shopping, etc., that was almost luxury. I was fine all the time, I did not have any pain, only a short breath at first. The shortness of breath became less and less with the breakdown of the heart water, so that I could walk slowly in November.

I was at my doctor's control every 14 days during this time, and at the next MRI check-up the diagnosis was extended to heart muscle inflammation. The heart water (Perikarderguss) developed only very slowly. My question, if I could go back to work soon, was vehemently denied. It was only in January 2008 that I was able to work again after 10 weeks. The reintegration in the office took place in agreement with my boss and the works council full time, because I had no complaints.

There were ultrasound ultrasound scans over the next few weeks and a final MRI in June 2008. The good result was that there were no scars left, but there was still a slight pericardial effusion visible. Since then, I have regularly (once a year) control the heart via ultrasound.

My way back to sports

In October 2007, I was banished to the couch, where I also spent almost 4 weeks.

Starting in November, I bravely went for a walk with sticks (Nordic Walking), for a full 20 minutes at the beginning. As a trainer, I have experience with heart rate measurement, so I have completed and controlled each workout only with heart rate measurement. I felt very comfortable with it. Very slowly, I then extended the trips.

From December I then switched to walking without sticks with hand weights. I was usually on the road for an hour. In the middle of December I started to install small jogging sections in the walking sections. Gradually, I have reduced the walking sections and expanded jogging. The time I did not extend, I was mostly 1 hour on the road.

During this time, I talked a lot with my friends, including the subject of triathlon. There are many triathletes around me who have all complained about the discipline of swimming. I could not understand that as I am a former competitive swimmer.

Then I came up with the idea to see if I would find fun swimming again. I got informed and was recommended the Bad Homburger Swimming Club, which has a good Masters ("Senior") team. After a "test swim" I am since January 2008 regularly twice a week in training. In the beginning, I was still swimming with my heart rate monitor to make sure my heart rate was not too high. I slowly increased my performance and rediscovered my love of swimming!

The good thing about the training in 2008 was that I really completed a basic endurance training par excellence from the age of 0.

In March 2008 we were in Mallorca in the training camp for cycling. I was very good with a women's group on the road and drove in my heart rate zone. I was fortunate enough to have an experienced triathlete in the group who has cared for me very sensitively.

In September 2008 I did my first Everyman Triathlon and was totally thrilled. In October, I ran my first 10 km race in Bad Homburg in less than 1 hour, I was very satisfied.

In January 2009, I swam my first swimming competition after a 30-year break. I did many competitions in 2009 (triathlon, running, duathlon, swimming) and was very happy with me.

Since then I regularly swim national and international competitions and am involved in triathlon and duathlon.

I can say that I have been lucky!

Never give up and make it happen!

Monika Sturm-Constantin

Sources:

1. //www.lichtkreis.at/html/Wissenswelten/Symbolik_Talismane/Deutung-symbol-herz.htm

2. //www.aks.or.at/angebote-fuer-erwachsene/bewegung/mehr-zum-thema-bewegung/vorbeugung/gesundes-herz-2013-gesunder-mensch/

3. //www.sportmedinfo.de/Todesfaelle.htm

4. //klinikum-bremen-mitte.medical-guide.net/englisch/H/HerzKreislaufDiseases/Heart Muscle Inflammation / page.html

5. //www.apotheken-umschau.de/herzbeutelentzuendung

6. //www.netdoktor.at/krankheiten/fakta/myokarditis.htm

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