We recommend obtaining an up to date personalised Exercise Prescription Form, completed by your cardiologist/nurse specialist/specialist physio. This form describes the types of activities that you can participate in, and at what intensity. If you have not already been given one of these forms, you can download and print three blank copies below, and ask your cardiologist, nurse specialist or specialist physio to complete it for you. You’ll have one copy to keep and one to give to your school. Your clinician will also be able to keep one on file.
Some people with a congenital heart condition can safely take part in sports and exercise at a vigorous intensity. However, some heart conditions limit the intensity of physical activity that should be undertaken. For these people, being physically active at too high an intensity could make them feel unwell, cause dizziness or fainting, and make their heart condition worse. Make sure to ask your cardiologist what level of exercise intensity is recommended for you.
- Duration and how often should I exercise?
Often people with a heart condition find that they need to stop and rest during physical activity, usually because they are not getting enough oxygen to their muscles. This may be due directly to the heart condition, or it may be that they are simply unfit.
When you are considering whether or not to take part in an activity, think about whether there will be opportunities to stop and rest. If you are taking part in organised activities, like team sports, then it is a good idea to make sure that the person organising the activity is aware of your heart condition.
- Type of activity
Different types of physical activity places different demands. Dynamic activities are ones where lots of muscle groups are used to bring about dynamic movement. Good examples of these are jogging and racket sports. Taking part in dynamic activities improves cardiovascular fitness and is, in general, good for your health.
- Competitive/recreational participation
Most sporting activities can be enjoyed either at recreational or a competitive level. Recreational means that there is no pressure to play for a long time or at a high intensity. It is not important to keep score or time, whilst competitive means that it is important to win or do better than other people.
- Medication (link to medication page)
People taking anticoagulant drugs such as warfarin and aspirin may bleed for a longer time following cuts and scrapes, and may also bruise more easily. For this reason, they are often advised to avoid contact sports. Precautions should be taken to reduce the likelihood of cuts and bruises, such as wearing protective clothing, such as elbow/knee pads, helmet and gloves when cycling.
- Implanted devices to control or restore heart rhythm
ICDs (implantable cardioverter defibrillators) and pacemakers are fitted to control abnormal heart rhythms (arrhythmia). Which physical activities are appropriate for you depends upon the cause of the arrhythmia. It is therefore very important to get clear advice from your cardiologist. It usually takes 4-6 weeks for the body to heal after an ICD or pacemaker has been implanted. You will be advised to avoid certain activities during this time, to ensure that the device’s leads are not moved from their current position. Contact sports, where there is a likelihood of physical impacts, should be avoided if you/your child have an ICD or a pacemaker. This is to avoid damage or movement of the device’s leads and to prevent injury to the area around the device. For some activities these risks may be reduced or eliminated by wearing appropriate clothing or padding. This must be discussed with your cardiologist first!
If you have an ICD card, make sure that it is carried with you at all times, but especially when taking part in physical activities. It is also a good idea for you to be accompanied by someone who knows about your heart condition when doing physical activities; they would then be able to help in the unlikely event that the ICD delivers a shock
What’s the difference between an ICD and a pacemaker?
A pacemaker helps control abnormal heart rhythms. It uses electrical pulses to prompt the heart to beat at a normal rate. It can speed up a slow heart rhythm, control a fast heart rhythm, and coordinate the chambers of the heart. Pacemakers can relieve some symptoms related to arrhythmias, such as fatigue or fainting. They can help a person who has an abnormal heart rhythm resume a more active lifestyle.
An ICD (implantable cardioverter defibrillator) monitors heart rhythms. It sends electrical pulses or shocks to the heart when it senses any abnormalities in heartbeat. For example, if a patient with an ICD has an irregular heartbeat or goes into sudden cardiac arrest, the device will send a shock to the heart to restore normal heart rhythm. This treatment is called defibrillation. Most new ICDs can act as both a pacemaker and a defibrillator. Many ICDs also record the heart’s electrical patterns when there is an abnormal heartbeat. This can help the cardiologist plan future treatment.
If you have been diagnosed with an abnormal heart rhythm it is especially important to make sure that you do a proper warm-up and cool-down to reduce the risk of arrhythmia.
Recent surgical procedures
During open heart surgery the breastbone (sternum) is divided to allow access to the heart. This procedure is called a sternotomy. It takes approximately 12 weeks for the sternum to completely heal; however; this can vary between individuals. For the first few weeks following the operation, you/your child will be advised to avoid activities that place strain on the sternum. Gradually, over a period of about 3 months, you will be able to return to normal life. However, contact sports, where there is a likelihood of physical impacts, should be avoided for at least 3 months following surgery.
Risk of injury
Assessing risk is all about good judgement. Consideration should be given to how likely an incident is to happen and how serious the consequences might be. Often it is possible to take extra precautions or adapt activities to reduce the risks. Many activities have a risk of physical impact. These include ‘contact sports’, such as rugby and judo, where contact with other participants is expected. In other activities, a physical impact may not be intended, but might be quite likely, for example; football, skiing and cricket.
Some heart conditions can cause people to feel dizzy, or even to fall unconscious (loss of consciousness is sometimes referred to as ‘syncope’). Some activities are particularly dangerous if the participant becomes dizzy or unconscious. These include: swimming, climbing, kayaking, horse riding and cycling. If there is a history of dizziness or fainting then it is important to think carefully about whether a particular activity is suitable.