A Guide to Sports & Adult Congenital Heart Disease

Season: 2002

Submitted By: Dr. Andreas Hoffmann

Sports and Activity

  • Regular physical activity has positive effects on most of the organs in the body
  • Physical activity makes you feel better
  • You may have restrictions based on your condition but they should not stop you from being as active as you can be

Sports and the Heart

  • The key to being active is regular, moderate activity (not maximum performance)
  • Regular: Three times a week for 30 minutes
  • Moderate: You should feel warm but not uncomfortable.

Can I die if I do sports?

  • Only a very small number of deaths from heart problems in young people is caused by exercise.
  • Even less are caused by playing sports.

How much can I do?

  • How much you should do will depend on your heart condition and how your own heart can perform when you exercise.
  • Most patients can do more than they think.
  • But some have to accept restrictions.

Getting Started

Some things they told you when you were a child may be different now; like:

  • You may have been told that exercise is dangerous
  • The doctor may have told you not to do any sports
  • Your family or school may have not allowed you to do sports or physical activity.

Problems to be prevented

  • Problems with your heart rhythm if you have a weak heart
  • Lack of fluid replacement when you are sweating
  • A big rise or fall in your blood pressure
  • Bruising; if you are on a blood thinner
  • Bone injuries

How the doctors decide restrictions

  • Is based on the type of sport or activity
  • The difficulty of the activity
  • How high it will make your heart rate go
  • How your heart might respond to activity and sports

Best guide for getting active

  • You are the best judge of what you can do
  • If you can’t talk and breath....slow down a little
  • Your doctor can order an exercise test before becoming active and give you a “target heart rate”
  • The doctor can guide your activity instructor based on your history

Examples of Activities

High energy activity

  • Cycling
  • Running
  • Boxing
  • Snow Skiing
  • Swimming
  • Tennis
  • Volleyball

Low energy activity

  • walking
  • hiking
  • golf
  • curling
  • gymnastics
  • horseback riding
  • diving

Burning Calories

  • Slow walking 200 kcal/h (in a 70 kg adult)
  • Hiking 300 kcal/h (in a 70 kg adult)
  • Fast walking 350 kcal/h (in a 70 kg adult)
  • Swimming 500 kcal/h (in a 70 kg adult)
  • Walking up hill 500 kcal/h (in a 70 kg adult)
  • Tennis 600 kcal/h (in a 70 kg adult)
  • Jogging 700 kcal/h (in a 70 kg adult)

Are you restricted?

No Restrictions

  • Mild Pulmonary Stenosis
  • Small Ventricular Septal Defect (VSD)
  • Small Atrial Septal Defect (ASD)
  • Repaired VSD or ASD
  • Repaired Tetralogy of Fallot (usually)
  • Mitral Valve Prolapse without arrhythmia
  • Prosthetic Valve with normal pump function

what about competitive activity ?

  • Patients with a heart condition usually
  • should not engage in competition.
  • There may however be some exceptions in very mild and uncomplicated cases.
  • This will have to be discussed with your heart specialist doctor.

Usually restricted to mild intensity sports (or no sports at all)

  • Importantly narrowed valves
  • Weak pumping chambers (ventricle)
  • Severe pulmonary hypertension
  • Most cyanotic patients (blue)
  • Some “Mustard” or “Fontan” patients

Avoid Body Impact

  • Marfan syndrome
  • Others with ascending aortic aneurysms
  • Patients on coumadin (warfarin)


  • Cardiac death in sports is rare
  • Sports related cardiac deaths in congenital patients who are followed in a specialized clinic are very rare
  • Your doctor can set your level of restriction and guide your activity level
  • Activity is good for your mind and body