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Sports_TOF_Overview.html
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Sports_TOF_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: Tetralogy of Fallot</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;
}
</style>
</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-TGA, s/p atrial switch (Mustard/Senning)</option>
<option value="TGA_Art">d-TGA, s/p arterial switch </option>
<option value="CCTGA">Congenitally-corrected 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 with <b>Tetralogy of Fallot (s/p repair)</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>
</ul>
<p> "Before participation in competitive sports, it is recommended that all athletes with repaired
tetralogy of Fallot should undergo evaluation, including clinical assessment,
ECG, imaging assessment of ventricular function, and exercise testing."
</p>
<p class="rec_class">(Class I Recommendation; Level of Evidence B)</p>
</section>
<section id="answer_arrow_section">
<section class="half_left_invisible">⇙</section>
<section class="half_right_invisible">⇘</section>
</section>
<section id="answer">
<section class="half_left">
<p class="sectiontitle">Normal function, no arrhythmia, no outflow tract obstruction</p>
<p>"Athletes without significant ventricular dysfunction (EF >50%), arrhythmias, or outflow tract obstruction
may be considered for participation in moderate- to high-intensity sports (class II–III).
To meet these criteria, the athlete must be able to complete an exercise test without evidence of exercise-induced arrhythmias,
hypotension, ischemia, or other concerning clinical symptoms."
</p>
<div class="verdict_maybe"><b>May consider Class II-III sports if exercise test reassuring</b> (see conditions above).</div>
<p class="rec_class">(Class IIb Recommendation; Level of Evidence B)</p>
</section>
<section class="half_right">
<p class="sectiontitle">Ventricular dysfunction, outflow tract obstruction, or recurrent arrhythmias</p>
<p>
"Athletes with severe ventricular dysfunction (EF < 40%), severe outflow tract obstruction, or
recurrent or uncontrolled atrial or ventricular arrhythmias should be restricted from all
competitive sports, with the possible exception of low-intensity (class IA) sports."
</p>
<div class="verdict_maybe"><b> Class IA sports = Maybe</b> (see conditions above)</div>
<p class="rec_class">(Class III Recommendation; Level of Evidence B)</p>
</section>
</section>
<p class="foot">
<b>Reference:</b> <a href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000240"><i>Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities. Task Force 4: Congenital Heart Disease.
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, EF = ejection fraction
</p>
</section>
<script>
function goThere(){
var disease = document.getElementById("dz").value;
location.href= disease+'_Overview.html';
}
function getState() {
var disease = document.getElementById("dz").value;
var sport = document.getElementById("spt").value;
if(disease && sport) {
console.log(disease);
console.log(sport);
console.log(disease+sport);
combo=disease+sport;
location.href = combo+'.html';
}
}
</script>
</html>