Primary prevention
Very little is known regarding effective measures to prevent myocarditis. Current aims of primary prevention are limited to preventing the development of a condition known to be associated with myocarditis. An example is having safe-sex practices to prevent infection with HIV.
In cancer patients undergoing treatment with immune checkpoint inhibitors (ICIs), serial ECGs and troponin measurements should be taken to detect subclinical ICI-related cardiovascular toxicity. Broader cardiovascular assessment should be considered every 6-12 months in patients who require long-term treatment.[32]
Secondary prevention
Ethanol abstinence is encouraged in all patients with a history of myocarditis, although the effects of modest alcohol consumption on non-alcohol-related cardiomyopathy are unknown. Avoidance of participation in competitive sports for 3-6 months after a diagnosis of myocarditis is recommended, including in children.[15][56] Avoidance of non-steroidal anti-inflammatory drugs (NSAIDs) is recommended in patients with advanced heart failure or cardiogenic shock due to myocarditis. However, aspirin and ibuprofen can be used in patients with acute myopericarditis who have mild symptoms and do not require hospitalisation.[56]
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