Abstract Introduction Although current guidelines recommend abstaining from sports for a duration of a minimum of three months in patients with myocarditis, the implementation of this recommendation and its adherence to it are unknown. Objective Investigate counselling and adherence to sports behaviour in patients with myocarditis. Methods A cohort of patients diagnosed with myocarditis, based on the ESC criteria, received questionnaires three months post-diagnosis to assess their activity levels before and after the diagnosis as well as the adherence to sports counselling. Results In our study, 46 myocarditis patients (11; 25% women) with a mean age of 52±14.5years were analysed. At the time of diagnosis, 39 patients (84%) reported physical activity, with 7 (15%) engaging in competitive sports. Following myocarditis diagnosis, 27 (60%) were recommended to abstain from sports or reduce physical activity, with 92% adherence. Of those 11 (23%) were physically active without receiving recommendations continued physical activity (p< 0.001). After three months, less patients were physically active (i.e. 25; 54% patients) compared to 39 (84%) patients at baseline (p = 0.038), 13 of those being physically active but with reduced exercise intensity according to recommendations. Of those who continued exercise without changes (n=13, 28%), only 2 (4%) reported having received recommendations. All competitive athletes (7, 15%) received counselling, whereas significantly fewer recreational athletes 19 (41%) did (p = 0.039). Women received numerical non-significant fewer counselling (4, 36% of all women, compared to 23, 67% of all men; p = 0.186). Conclusion Middle-aged individuals with suspected myocarditis exhibit excellent adherence to recommendations regarding physical activity. However, a notable proportion did not recall receiving counselling on exercise and physical activity. This highlights the need for clinicians to provide comprehensive counselling to all patients with suspected myocarditis consistently.Illustrating the sports behaviourcomparing activity at 0 and 3 months