[Sports and congenital heart disease in the adult].
The practice of sporting activities is not only allowed, but also should be recommended for most adult patients affected by congenital cardiopathy. This permissive attitude should be based on a good understanding of congenital cardiopathy, whether operated or not, and its foreseeable evolution in adulthood. Aptitude for sport should be supported by a precise evaluation of the patient's functional, rhythmological and haemodynamic status at rest and under effort. Regular monitoring is often justified, and is greatly facilitated by the quantity and quality of modern non-invasive surveillance methods, the first of which are Doppler echocardiography and ergometric techniques. The stress test should be readily coupled with a study of ventilatory parameters under effort, as there are frequently disturbances of pulmonary exchange. Non-competitive sporting activity is generally implied for congenital cardiac patients, but there are exceptions in certain cases. Patients should generally be directed towards an endurance sport, undertaken without any spirit of competition, as a function of the results from effort tests (easy confrontation for this type of sport). It is only based on the tolerance of this basal activity that other sports are then authorized. It is illusory to demand systematisation for sporting aptitude in each type of cardiopathy as the situations encountered in practice vary from one individual to another. It is nevertheless possible to define a certain number of guidelines which are suitable for modification for each patient as a function of the clinical history, any associated vascular risk factors, and the patient's motivation. All said and done, absolute contra-indications to sport are rare. Relative contraindications to a type of sport or to a level of sporting activity as a function of the cardiopathy are encountered more and more. Nowadays the selective aptitude for certain sports should be discussed rather than the contra-indications. Under these conditions, sport can only be beneficial for adult congenital cardiac patients, and it plays a part in the prevention of the acquired risk of cardiopathy from which these patients have no escape.
Marçon
F
F
Service de cardiologie pédiatrique, hôpital d'enfants, CHU de Nancy, allée du Morvan, 54511 Vandoeuvre-les-Nancy.
D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology; D017408:Guidelines as Topic; D006304:Health Status; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D010809:Physical Fitness; D012307:Risk Factors; D012720:Severity of Illness Index; D013177:Sports