Pedi CardioRef
Reference: ACC/AHA Sports Participation Recommendations (Circulation 2015) Task Force 7: Aortic Diseases, Including Marfan Syndrome

participate in organized sports?

Should my patient with Bicuspid Aortic Valve participate in organized sports?

Bicuspid Aortic Valve


Need to know:

Need to perform:

"Athletes with BAV and aortic dimensions above the normal range (scores 2–3 or aortic diameters measuring 40–42 mm in men or 36–39 mm in women) should undergo echocardiographic or MRA surveillance of the aorta every 12 months, with more frequent imaging recommended for increasing aortic z score."

(Class I Recommendation; Level of Evidence C)

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No dilation

"Athletes with BAV can participate in all competitive athletics if the aortic root and ascending aorta are not dilated (ie, z score < 2, or < 2 standard deviations from the mean, or < 40 mm in adults). The function of the BAV (whether stenotic or regurgitant) is also important in determining participation recommendations (see Task Force 5 on valvular heart disease)."

All sports = acceptable (but see Task Force 5)

(Class I Recommendation; Level of Evidence C)

Mild-moderate aortic dilation, no connective tissue disorder

"For athletes with a BAV and a mild to moderately dilated aorta (score 2–3.5 or aortic root or ascending aortic diameters measuring 40–42 mm in men or 36–39 mm in women) and no features of associated connective tissue disorder or familial TAA syndrome, participation in low and moderate static and dynamic competitive sports with a low likelihood of significant bodily contact (classes IA, IB, IC, IIA, IIB, and IIC) may be considered. For these athletes, avoidance of intense weight training should be considered."

Class IA, IB, IC, IIA, IIB, IIC with low likelihood of bodily contact = may consider. Also, avoid intense weight training.

(Class IIb Recommendation; Level of Evidence C)

Aorta 43-45mm

"For athletes with a BAV and a dilated aorta measuring 43 to 45 mm, participation in low-intensity competitive sports (class IA) with a low likelihood of bodily contact may be considered."

Class IA with low likelihood of bodily contact = may consider.

(Class IIb Recommendation; Level of Evidence C)

Severe aortic dilation

"Athletes with BAV and a severely dilated aorta (score >3.5 to 4 or >43 mm in men or >40 mm in women) should not participate in any competitive sports that involve the potential for bodily collision."

No sports that involve potential for bodily collision

(Class III Recommendation; Level of Evidence C)


Athletes with BAV and a markedly dilated aorta (>45 mm) should not participate in any competitive sports.

No competitive sports

(Class III 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 Task Force 7: Aortic Diseases, Including Marfan Syndrome

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: BAV = bicuspid aortic valve, MRA = magnetic resonance angiography