Pedi CardioRef
Reference: ACC/AHA Sports Participation Recommendations (Circulation 2015)

participate in organized sports?

Should my patient with Enlarged Aorta, without syndrome, non-familial participate in organized sports?

Aortic dimensions above the normal range*
& no features of Marfan syndrome, Loeys-Dietz, or familial TAA syndrome

(*z scores >2, or aortic root diameters measuring >40mm in tall men or >35mm in tall women)


Need to perform:

"Athletes with aortic dimensions mildly above the normal range (z scores 2–2.5 or aortic root diameters measuring 40–41 mm in tall men or 36–38 mm in tall women) and no features of Marfan syndrome, Loeys-Dietz syndrome, or familial TAA syndrome should undergo echocardiographic or MRA surveillance every 6 to 12 months, with imaging frequency dependent on aortic size and stability of measurements."

(Class I Recommendation; Level of Evidence C)

Participation Criteria:

"For athletes with aortic dimensions mildly above the normal range (scores 2–2.5 or aortic root diameters measuring 40–41 mm in tall men or 35–37 mm in tall women) and no features of Marfan syndrome, Loeys-Dietz syndrome, familial TAA syndrome, or BAV, participation in all competitive athletics may be considered after a comprehensive evaluation for an underlying genetic condition associated with aortopathy is performed.

This may include analysis for mutations in FBN1 and other genes associated with aortopathies in certain circumstances."

Can consider all sports, after comprehensive evaluation for genetic condition is performed.

(Class IIb Recommendation; Level of Evidence C)


"For athletes with aortic dimensions mildly above the normal range (scores 2–2.5 or aortic root diameters measuring 40–41 mm in tall men or 35–37 mm in tall women) and no features of Marfan syndrome, Loeys-Dietz syndrome, familial TAA syndrome, or BAV, avoidance of intense weight training may be considered."

Can consider avoidance of intense weight training

(Class IIb Recommendation; Level of Evidence C)

Reference: Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force . A Scientific Statement From the AHA and ACC. Circulation 2015

Disclaimer: 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.

Key: TAA = thoracic aortic aneurysm, BAV = bicuspid aortic valve