r/myocarditis

Hi all

Sharing a bit and hoping to learn from others.
About a year ago I had viral myocarditis, went back to training too soon, and had a recurrence. My latest MRI showed about 16% scarring (subepicardial, infero-lateral) but my EF is still basically borderline (~51%).

During my last visit the focus has moved from healing to managing long-term risk, including whether I might need an ICD down the line. Genetic testing is still pending.

If you had a normal EF but real scarring, how did your team handle the ICD question? I know that I’m in a grey zone as my EF is conserved but the scar burden is unfortunately above the ICD guidelines.

Not looking for medical advice, just real experiences. Thanks — this community has helped a lot.

I am an 18-year-old male who has been doing regular resistance training for about three years. I had no chest pain, shortness of breath, palpitations, reduced exercise tolerance, or other cardiac symptoms.

A high-sensitivity troponin I elevation was found unexpectedly during routine blood testing. The initial result was approximately 7 times the laboratory’s upper reference limit. I was admitted for observation and underwent several ECGs, two echocardiograms, and a chest X-ray. All were reported as normal. My ejection fraction was around 72%, and no structural or functional cardiac abnormality was found.

After stopping exercise completely, my troponin I decreased only slightly over one week, from roughly 7 times to 6 times the upper reference limit. The values are not showing a clear rise-and-fall pattern and have remained close to the same range for several days. I still have no symptoms. My CRP, kidney function, CK, and liver enzymes are currently normal.

The pediatric cardiologists I have seen initially considered mild myocarditis or exercise-related elevation, but later felt myocarditis was unlikely because the ECGs, echocardiograms, chest X-ray, and clinical examination were all normal. Their current plan is simply rest and repeat testing.

I would appreciate opinions on what possibilities should be considered in a case like this. In particular:
- Can exercise or infection related troponin elevation remain around 6–7 times the upper reference limit for more than a week after stopping training?

- Could mild or focal myocarditis still cause this pattern despite normal ECG and echocardiography?
Should assay interference or macrotroponin I be investigated? (asking this since I've found some articles about these cases)

Would measuring hs-troponin T on a different platform, repeating troponin I testing or cardiac MRI be reasonable next steps?
I am mainly trying to understand what further evaluation would be appropriate rather than repeatedly measuring the same troponin I assay and waiting indefinitely.
Note: I dont have any single medical problem except troponin levels