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Sports_Fontan_Overview.html
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Sports_Fontan_Overview.html
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<!DOCTYPE html>
<html lang="en">
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<meta name="viewport" content="width=device-width, initial-scale=1" />
<head>
<meta charset="UTF-8">
<title>CardioRef: AHA/ACC 2015 Sports Participation Selector Guide: Fontan </title>
<link rel="stylesheet" href="css/sports_answer_combined.css">
<style>
div{
-webkit-margin-before:0;
-webkit-margin-after:0;
-webkit-margin-start:0;
-webkit-margin-end:0;
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</head>
<body>
<div class="topbar">
<a href="index.html">Pedi CardioRef</a>
<div class="guidelinebar">
<a target="_blank" rel="noopener noreferrer" href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000240">
Reference: ACC/AHA Sports Participation Recommendations (Circulation 2015) Task Force 4: Congenital Heart Disease</a>
</div>
</div>
<section style="margin:10px">
<p class="topspace"></p>
<label><b>By the ACC/AHA 2015 guidelines, should my patient with</label>
<select name="disease" id="dz" class="InputBox" onChange="goThere();">
<option value="">*Select Disease*</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HCM">Hypertrophic Cardiomyopathy </option>
<option value="LVNC">Left Ventricular Non-Compaction </option>
<option value="DilRestr">Dilated or Restrictive Cardiomyopathy </option>
<option value="ARVC">Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) </option>
<option value="Myo">Myocarditis </option>
<option value="Peri">Pericarditis </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="ASDVSDPDA">ASD, VSD, or PDA </option>
<option value="PS">Pulmonic Stenosis </option>
<option value="AS">Aortic Stenosis </option>
<option value="Coarct">Coarctation </option>
<option value="Cyan">Cyanotic Heart Disease, unrepaired or with palliative shunt </option>
<option value="TOF">Tetralogy of Fallot, s/p repair </option>
<option value="TGA_Must">d-transposition (d-TGA), s/p atrial switch (Mustard/Senning)</option>
<option value="TGA_Art">d-transposition (d-TGA), s/p arterial switch </option>
<option value="CCTGA">Congenitally-corrected TGA (CC-TGA, L-TGA)</option>
<option value="Fontan">Fontan </option>
<option value="Ebstein">Ebstein Anomaly </option>
<option value="AnomCoronary">Anomalous Coronary Artery Origin</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="PVR">Elevated PVR in CHD </option>
<option value="VentricularDysfxn">Ventricular Dysfunction s/p CHD Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Valve_AS">Aortic Stenosis</option>
<option value="Valve_AR">Aortic Regurgitation </option>
<option value="Valve_MS">Mitral Stenosis</option>
<option value="Valve_MR">Mitral Regurgitation </option>
<option value="Valve_Hx">History of Mitral or Aortic Valve Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HTN">Hypertension </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="AoDiseases_and_Marfan">Aortic Diseases and Marfan Syndrome</option>
<option value="BAV">Bicuspid Aortic Valve</option>
<option value="Marfan">Marfan Syndrome</option>
<option value="TAA">Thoracic Aortic Aneurysm, familial or unexplained</option>
<option value="LoeysDietz_EhlersDanlos">Loeys-Dietz or vascular Ehlers-Danlos</option>
<option value="AoEnlarge">Enlarged Aorta, non-syndrome non-familial</option>
<option value="Ao_Surgery">S/p Surgery for Aortic Enlargement/Dissection</option>
<option value="Chronic_AoDissection">Chronic Aortic Dissection or Branch Aneurysm</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="CoronaryOverview">Coronary Artery Disease </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Syncope">Syncope </option>
<option value="Arrhythmia">Arrhythmias (SVT, PVC, Vtach, etc.) </option>
<option value="ConductionDefect">Conduction Defects (AV block, brady, pacemaker, RBBB/LBBB)</option>
<option value="Channelopathies">Channelopathies (LQTS, CPVT, Brugada, etc.) </option>
<option value="ICD">Implantable Cardioverter-Defibrillator (ICD) </option>
</select>
<span>participate in organized sports?</span></b>
<br><br>
<section id="question">
Should my patient <b>with Fontan physiology</b> participate in organized sports?
</section>
</section>
<br>
<section id="needtoknow">
<p class="sectiontitle">Need to perform:</p>
<ul>
<li>Clinical assessment</li>
<li>ECG</li>
<li>Imaging of ventricular function</li>
<li>Exercise testing</li>
<p>"It is recommended that before participation in competitive sports,
all athletes who have undergone the Fontan procedure should undergo an evaluation that
includes clinical assessment, ECG, imaging assessment of ventricular function, and exercise testing."</p>
</ul>
<p class="rec_class">(Class I Recommendation; Level of Evidence B)</p>
</section>
<p class="arrowsdouble"> ⇓</p>
<section id="answer">
<section class="single_center">
<p class="sectiontitle">No symptomatic heart failure or significantly abnormal hemodynamics</p>
<p>"Athletes who have undergone the Fontan procedure and who have no symptomatic heart failure or
significantly abnormal intravascular hemodynamics can participate only in
low-intensity class IA sports."
</p>
<div class="verdict_maybe">Only Class IA</div>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
</section>
<p class="arrowsdouble"> ⇓</p>
<section class="single_center">
<p class="sectiontitle">After exercise test assessment</p>
<p>"Participation in other sports may be considered on an individual basis with regard for the
athlete’s ability to complete an exercise test without evidence of exercise-induced arrhythmias,
hypotension, ischemia, or other concerning clinical symptoms."
</p>
<div class="verdict_maybe">May consider sports beyond Class IA on an individual basis.</div>
<p class="rec_class">(Class IIb Recommendation; Level of Evidence C)</p>
</section>
</section>
<p class="foot">
<b>Reference:</b> <a href="https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000236"><i>Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities.
A Scientific Statement From the AHA and ACC.</i></a> <i>Circulation 2015</i>
<br><br><b>Disclaimer:</b> This website is derived from published guidelines, but does not constitute medical advice nor does it replace clinical judgement. Only the text in quotation marks are direct quotations from the original guidelines. Text not in quotations as well as the method of information display are all that of the website creator and are not part of the original published guidelines. Please consult a physician to discuss any patient-specific matters.
</p>
<section class="key">
<p><b>Key:</b> ECG = electrocardiogram, LV = left ventricle, RV = right ventricle,
echo = echocardiogram
</p>
</section>
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