‘I Damaged My Heart By Exercising After A False-Negative Mono Test’

Photo credit: Chloe Gottschalk
Photo credit: Chloe Gottschalk

From Women's Health

Soccer was my life growing up, and all of that hard work felt like it paid off when I was recruited to play division I soccer in college. My first season, fall 2014, was a big transition, but I was holding my own and in great cardiovascular shape...until that following spring when I started noticing things were really off: I had a fever, sore throat, and severe fatigue.

That April my best friend was diagnosed with mononucleosis (a.k.a. mono), and because my symptoms were similar, the campus health center gave me a mono spot test. My results came back negative, and I was told that I had the flu. (I now know mono tests sometimes gives a false negative during the first week of infection, according to the Cleveland Clinic.)

I took two days off to let my fever break and then went back to practice because I didn’t have a doctor’s note saying I was sick. Despite my fatigue, I played until the end of that school year. My athletic trainers would ask how I was feeling, and I would say I was really tired but fine. I convinced myself that my symptoms were all in my head. I also didn’t want my coaches or teammates to think I was making it up so I didn’t have to practice. But I knew something was seriously wrong when I collapsed mid-workout. I passed out after running a quarter-mile. My knees just buckled. I knew I needed help.

My family doctor got me an EKG (electrocardiogram, which tests the electrical activity of the heart, per the American Heart Association). The results came back abnormal. That’s when it clicked that what I was feeling was real. I wasn’t being dramatic. I wasn’t just trying to get out of workouts. My doctor told me she couldn’t clear me for practice and sent me to a cardiologist.

That feeling of relief was short-lived, though. The heart specialist said that my EKG was a fluke and told me I was fine. Yes, my resting heart rate was really low, at 40 to 42, but that was normal for an athlete. I left his office feeling like my worries weren't valid, even though they felt very real. But the diagnosis was that I was young, and my EKG wasn’t all that abnormal.

Too wrong to be right

I went back to pre-season training that August thinking everything must be fine. But I tired quickly, and sprints made my chest feel super tight. I figured I just needed to work harder to get back in shape after taking a month off. My athletic trainer told me I needed to go to the school health center to get my physical paperwork signed before I could start practicing officially. Doctors there did three more EKGs, all of which came back abnormal, and I was told I couldn't play until they figured out what was going on with my heart.

I spent the next two months running between doctor appointments. They tested me for everything—brain damage, autoimmune disease, multiple sclerosis, asthma, allergies—without finding answers.

It was at that point that my mom took me to a new doctor's office, and they initially just told me to stop playing soccer. She persisted, asking them to run more tests, and I was admitted to the hospital after my heart rate spiked from 42 to 180 just from standing up.

I spent four nights there, and doctors eventually discovered that my heart was enlarged. I was diagnosed with myocarditis and pericarditis, which the Mayo Clinic describs as inflammation of the heart muscle and tissues surrounding the heart. (Myocarditis usually happens when a virus, like the flu or mono, which is caused by the Epstein-Barr virus, enters the heart cells and the immune system continues to fight even after the threat's been eliminated.)

“The problem is not only the virus. In fact, it’s mostly the dysregulated response of the immune system,” says Mathieu Kerneis, MD, a cardiologist at Pitié-Salpêtrière Hospital in Paris, France, who specializes in myocarditis. “We don’t know exactly how or why a virus causes myocarditis, but we think there’s a genetic susceptibility.”

Fortunately (or rather, unfortunately, for me), myocarditis is rare, affecting about 100 to 200 people per million worldwide every year, according to the National Institutes of Health. (To put that in perspective, the flu affects about 300,000 out of every million Americans annually, per the Centers for Disease Control.)

Still, myocarditis is most common in young adults, though the average age for acute cases is 20 to 51 years, according to research from the U.S. Department of Health and Human Services. It's a leading cause of sudden cardiac death in young people, according to the Myocarditis Foundation, and cardiac arrest is the number one killer of athletes under the age of 35, per the Mayo Clinic. So, if we're talking about the impact it can have on a specific population, it's something to take seriously. Its common symptoms include chest pain, shortness of breath, and heart palpitations that usually occur about three days to two weeks after a person gets sick.

The tricky thing about myocarditis, though, is that outcomes vary so much from person to person. “Some people will have very few symptoms, and others will require heart transplants,” says Dr. Kerneis.

Connecting the dots

During my hospital stay, doctors finally started to put everything together, and I was tested for mono again. This time, the results came back positive. I was told that I shouldn’t have been exercising with mono because it put too much stress on my body. I was told I should quit soccer or risk of damaging my heart further. That news was heartbreaking on a different level. I wasn’t ready to give it up.

Soccer was my destiny and identity: I was Chloe the soccer player. I didn’t know who I’d be or what I’d do without it. All my friends were on the team. I'd cry when they left for games.

After I was discharged from the hospital, my doctors enforced a zero-exercise policy for three months. I then began easing back in with light cardio and drills. Eventually, I was temporarily cleared to play soccer again, which I did for a year. But after awhile, it felt like I was doing my body more harm than good. Finally, two years after first feeling unwell, my family doctor medically disqualified me because he was worried about the long-term effects of allowing me to continue to play. I was devastated. I felt life cheated me out of an opportunity that I’d worked so hard to achieve.

I felt especially lost fitness-wise. My whole life I had a team and coach telling me what workouts to do, and now I was alone in my fitness journey. I stopped working out entirely for a month while I figured out what I wanted to do.

When I began exercising on my own, it was hard to accept that high-intensity training wasn't for me anymore. But my senior year in school, I started following female weight lifters on Instagram and working out the way they did. I’d save their posts, break down their workouts, and build my own. I found that weightlifting challenged me without causing symptoms.

Right before I graduated in 2018, I started my Instagram account, ChloeGottsFit, to hold myself accountable. I didn’t plan on having a platform, but it blew up unexpectedly. Now, I’m a certified personal trainer in Denver and founder of Bloom By Chloe workout gear. I don’t think I would be where I am today if I didn’t go through those health challenges. They really taught me to trust my instincts. I know my body better than anyone. I put so much trust in doctors, but they weren’t experiencing my symptoms firsthand. Now if I feel something’s off, I go to the doctor and don’t just assume it will pass. I advocate for myself.

These days I keep my cardio pretty light, since it doesn’t take much for me to feel dizzy and short of breath, and do it two to three times per week. I lift five days per week, by comparison.

I still don’t entirely understand what happened to my heart. For a few years, I was so angry about it. Today I’ve learned to be grateful for what I have—my result could have been so much worse. Hanging up my cleats was the hardest choice I'd ever had to make. But here's the thing: By losing soccer, I found a new love for fitness, something that makes me feel happy and full again.

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