Table 1

Proposed use of cardiac MRI (CMR) in athletes after SARS-CoV-2 infection

CMR indicated:Clinical symptoms suspicious for SARS-CoV-2-related cardiac injury (eg, chest pain, significant exercise intolerance without clear pulmonary aetiology, new palpitations or syncope) and ≥1 abnormal cardiac test (abnormal ECG, troponin, transthoracic echocardiogram or ventricular arrhythmias on monitoring or stress testing)
OR
New clinical symptoms concerning for SARS-CoV-2-related cardiac injury (eg, chest pain, significant exercise intolerance without clear pulmonary aetiology, new palpitations or syncope) on return to exercise after initial normal cardiac testing
CMR can be considered:High clinical suspicion for SARS-CoV-2-related cardiac injury (eg, chest pain, significant exercise intolerance without clear pulmonary aetiology, new palpitations or syncope) despite normal cardiac testing
OR
Moderate systemic non-cardiac symptoms related to SARS-CoV-2 (eg, prolonged fever >48 hours, prolonged severe myalgias >48 hours, severe lethargy) and ≥1 abnormal cardiac test
CMR not recommended:Screening in asymptomatic or mildly ill* athletes unless as part of a research study
  • *Mild symptoms include upper respiratory tract (congestion, coryza, sore throat, headache), gastrointestinal (nausea, vomiting, diarrhoea), anosmia, ageusia, mild fatigue and fever/chills/myalgias <48 hours.