Return-to-play in an endurance athlete with recurrent pericarditis and transient pericardial constriction: A case report

• Mireia Guarner Piquet ^[1]
  1. [1] Centre Atenció Primària Terrassa Nord. Consorci Sanitari Terrassa
• Localización: Apunts: Medicina de l'esport, ISSN 0213-3717, ISSN-e 1886-6581, Vol. 60, Nº 228, 2025
• Idioma: inglés
• DOI: 10.1016/j.apunsm.2025.100492
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• Resumen

  • Recurrent pericarditis management is a significant challenge, especially in athletes, due to the recommendation of exercise restriction. It requires a comprehensive, multidisciplinary approach balancing treatment efficacy with a tailored return-to-play (RTP) strategy.

    We present the case of a 28-year-old female endurance runner suffering from recurrent pericarditis and transient pericardial constriction. Initial management included nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine, alongside strict restriction from moderate-to-intense physical activity. Following a second episode with constrictive features, serial cardiac magnetic resonance (CMR) imaging demonstrated progressive resolution of pericardial thickening and inflammation, allowing for a gradual pharmacological withdrawal and a structured reintroduction of physical activity.

    This case underscores the importance of individualized exercise prescription and close clinical monitoring in athletes recovering from pericarditis. Given the limited evidence addressing exercise restriction in pericarditis, adherence to current guidelines based on expert consensus and a flexible, tailored approach are essential for optimal outcomes.

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