This post was authored by Robert Beekman, MD, FACC, chair-elect of the Adult Congenital and Pediatric Cardiology Section Leadership Council.

A new scientific statement recently published in Circulation points out that children and adults with congenital heart disease (CHD) need physical activity as much as individuals who do not have heart disease. The statement lays out the rationale for increased physical activity in persons with CHD and guidelines to help direct clinicians in their exercise recommendations. The statement, authored by Patricia Longmuir, PhD, Hospital for Sick Children, Toronto, and colleagues, explains that there is almost no research on physical activity in populations with CHD, but there are clear physical and psychosocial benefits gained from increased physical activity in groups in which activity has been studied. With the possible exception of some individuals with rhythm disorders or severe LV outflow obstruction, there is no indication in the literature that recreational physical activity among CHD patients should be restricted. At the same time, many CHD patients are relatively sedentary and at risk for exercise intolerance, obesity and psychosocial morbidities. Encouraging patients to engage in appropriate levels of physical activity can improve their overall medical condition and quality of life.

However, health care professionals must tailor exercise recommendations to each patient’s clinical status. Competitive sports may or may not be appropriate, but few CHD patients have disease that significantly restricts physical activity with family and friends. Only a very limited number of diagnoses, such as risk of ventricular arrhythmia or severe LV outflow obstruction, necessitate a priori activity restrictions in CHD patients.

The authors also note that existing physical activity guidelines for CHD patients are seldom evidence-based, and are typically directed at adolescents and adults engaged in intensive training for competitive sports. Training for competitive activity typically involves near-maximal exertion, a very different scenario from recreational activities that typically involved 50 percent to 60 percent of maximal exertion.

The statement underscores the need for promoting physical activity in CHD patients, and because many clinicians are limited in both time and knowledge of exercise and exercise physiology, providers must be prepared to refer patients to physical activity professionals, similar to the way they routinely refer patients for dietary counseling or therapy.

Check out the Congenital Heart Defects condition center on CardioSmart.org for more information on the importance of heart healthy habits for CHD patients.

< Back to Listings