Congenital heart disease and exercise.
Though initially challenging, the process of determining appropriate levels of exercise for patients with congenital heart disease can be broken down into several practical steps: List 1: Summary of approach to CHD patients and exercise Get the records: Surgical reports, diagnostic test results, office visits, admissions [table: see text] Obtain family history: Family members with sudden death increase risk. Thorough physical exam: Special attention to auscultation of murmurs Appropriate diagnostic testing: Noninvasive testing is usually adequate. Review guidelines: 26th Bethesda Conference, 1994 [13] Make recommendation: Be specific about types of exercise allowed. Reassess at least annually: Patients' status may change over time [24]. The use of this algorithm and review of available guidelines, in combination with selected consultation with other specialists, should allow the sports physician to prescribe exercise for the majority of these patients confidently. Examples of several congenital defects of varying severity, and the appropriate exercise prescription, are listed in Table 1.
Dent
John M
JM
Adult Echocardiography and Exercise Stress Laboratories, University of Virginia Health System, Box 800662, Charlottesville, VA 22908, USA. jmd5k@hscmail.mcc.virginia.edu
D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control; D015444:Exercise; D006330:Heart Defects, Congenital / Q000145:classification / Q000150:complications*; D006801:Humans; D017410:Practice Guidelines as Topic; D013177:Sports