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A closer look at Red Sox pitcher Eduardo Rodriguez’s struggle with myocarditis - The Boston Globe
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The reason for caution is obvious. The consequence of stressing the heart when myocarditis is present isn’t merely a threat to a career. It is a potential threat to life.
That worst-case scenario informed a corresponding response, chiefly having Rodríguez avoid physical exertion for a period of three months. Yet despite that restriction — which spanned the 2020 season — the Red Sox and Rodríguez are optimistic about the pitcher’s outlook. He’s expected to have a normal offseason and considered likely to be ready for the start of the 2021 season.
“I was confident, first of all, listening to the doctors that were handling Eduardo and finding out that he was under real good care,” said Rodríguez’s agent, Scott Pucino of Octagon. “Even though it’s frightening to hear about the heart, you know that the care that the Boston Red Sox had with the cardiologists, how confident they were that, hey, shut this down and things will be OK."
Despite that assessment, Rodríguez offers a reminder of the uncertainties that accompany the coronavirus. After all, after testing positive for COVID-19 before reporting for training camp in July, the 27-year-old lefthander was cleared to join the team following multiple negative tests in July.
He’d been able to throw into a net during his quarantine, and once in Boston, had thrown two bullpen sessions while trying to prepare for the season. But fatigue in the second of those sessions at Fenway Park led to the MRI that resulted in the diagnosis of myocarditis.
Much remains unknown about the relationship between COVID-19 and the cardiac health of athletes who are attempting to return to play. Medical researchers are still trying to gain insight into the impact of the virus on cardiac health and the frequency in both the general population and athletes of such impacts.
As such, the effort to define the best practices for how to ensure the safe return of players coming back from COVID-19 infections to their sports remains ongoing.
“There’s still so much of a mystery with COVID in general," said Dr. Jonathan Kim, the chief of sports cardiology at Emory University. “We’re left in this very challenging arena where we obviously know COVID can impact the heart in hospitalized patients. We’re worried about the potential impact on athletes because if myocarditis is present, myocarditis is a common cause of sudden death. Adverse events can happen if you intensely exercise and there is active inflammation in the heart. But there are all these unknown questions as it relates to how much cardiac injury occurs in patients, including athletes, who are not as sick with COVID or may have an asymptomatic infection.
“Hopefully sooner rather than later we’ll have a better idea about how much cardiac injury occurs in athletes who are not as ill with COVID-19. We will learn about the effectiveness of our current screening procedures. We’ll let the science drive us. But in terms of the evidence and published science out there right now, the data are pretty minimal and limited right now.”The limited data pool in turn means that there isn’t a definitive playbook to follow, a notion acknowledged by the Red Sox in the case of Rodríguez.
“There’s no precedent for this,” chief baseball officer Chaim Bloom said at the end of the season. “There’s such a limited history of athletes with myocarditis, there’s no history of athletes with COVID myocarditis, and we need to make sure we’re putting Eddie’s health first and foremost.”
The Red Sox appear to be following standard practices for treating athletes who experience myocarditis that isn’t the product of COVID. The prescription of three months of rest is standard for athletes diagnosed with myocarditis. For now, that same period of inactivity — which Kim said yields a full recovery of the heart in the majority of cases — is being prescribed for those who develop myocarditis after testing positive for COVID-19.
