Playing sports with congenital heart disease

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Learn about safe levels of activity for adults with congenital heart disease. Activity generally has positive effects on the body and its organs.

Key points

  • If you have a heart condition, how much activity you should do depends on how your heart performs when you exercise.

Regular physical activity has positive effects on most organs in the body, including the brain.

The key to being active is regular, moderate activity (not maximum performance). This means exercising three times a week for 30 minutes. Moderate exercise should make you feel warm but not uncomfortable.

Examples of activities

High intensity

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

Low intensity

  • Walking
  • Hiking
  • Golf
  • Curling
  • Gymnastics
  • Horseback riding
  • Diving

Typical calorie burn for selected activities in a 70 kg (154 lb) adult

  • Slow walking – 200 kcal/h
  • Hiking – 300 kcal/h
  • Fast walking – 350 kcal/h
  • Swimming – 500 kcal/h
  • Walking uphill – 500 kcal/h
  • Tennis – 600 kcal/h
  • Jogging – 700 kcal/h

Monitoring activity levels

How much activity you should do depends on your heart condition and how your own heart can perform when you exercise.

If you have a weak heart, there are usually concerns over:

  • 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.

​You are the best judge of what you can do. If you cannot talk and breathe, slow down a little. Your doctor can order an exercise test before you become active and give you a “target heart rate”. If you have an activity instructor, the doctor can guide them based on your history.

Restrictions on activities

Most patients can do more than they think, but some have to accept restrictions. Your doctor may set restrictions based on:

  • the type of sport or activity you are considering
  • the difficulty of the activity
  • how high your heart rate will go when doing the activity
  • how your heart might respond to activity and sports in general.

Heart conditions that generally do not need restrictions

  • Mild pulmonary stenosis
  • Small ventricular septal defect
  • Small atrial septal defect
  • Repaired ventricular septal defect or atrial septal defect
  • Repaired Tetralogy of Fallot (usually)
  • Mitral valve prolapse without arrhythmia
  • Prosthetic valve with normal pump function

Heart or circulation conditions that need restrictions on all but mild intensity sports

  • Narrowed valves
  • Weak pumping chambers (ventricle)
  • Severe pulmonary hypertension
  • Cyanosis
  • Heart conditions needing repair through Mustard or Fontan procedures

Patients who should avoid contact sports

  • Patients with Marfan syndrome
  • Patients with ascending aortic aneurysms
  • Patients taking warfarin​​​​

Some things they told you as a child may be different as you get older. Your condition may change over time, so restrictions may need to be reconsidered. Consult with your doctor.​

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.

Death and sports

Exercise causes only a tiny number of deaths from heart problems in young people. Sudden cardiac death is often connected to an undiagnosed arrhythmia; even fewer deaths are caused by playing sports. If an adult is at any increased risk, the cardiologist will indicate this and discuss appropriate activities.​​

Last updated: December 14th 2009