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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)

Summary

• 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