Coarctation, unrepaired

Need to know:

Ascending aorta dilation?
Exercise-induced hypertension?
Coarctation gradient

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No ascending aorta dilation, normal exercise test, < 20mmHg gradient

"Athletes with coarctation and without significant ascending aortic dilation (z score ≤3.0; a score of 3.0 equals 3 standard deviations from the mean for patient size) with a normal exercise test and a resting systolic blood pressure gradient < 20 mm Hg between the upper and lower limbs and a peak systolic blood pressure not exceeding the 95th percentile of predicted with exercise can participate in all competitive sports."

All sports are likely acceptable, if the above conditions are met.

(Class I Recommendation; Level of Evidence C)

Ascending aorta dilation, exercise-induced hypertension, or > 20mmHg gradient

"Athletes with a systolic blood pressure arm/leg gradient >20 mm Hg or exercise-induced hypertension (a peak systolic blood pressure exceeding the 95th percentile of predicted with exercise) or with significant ascending aortic dilation (z score >3.0) may be considered for participation only in low-intensity class IA sports."

May only consider low-intensity class IA sports (bowling, cricket, curling, golf, riflery, yoga)

(Class IIb Recommendation; Level of Evidence C)

Coarctation, treated by surgery or balloon and stent

Need to know:

How long since repair
Residual gradient
Exercise test results
Ascending aorta dilation
Repair-site aneurysm
Aortic valve disease?

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Greater than 3 months post op, < 20mmHg gradient, and all other conditions above normal

"Athletes who are >3 months past surgical repair or stent placement with < 20 mm Hg arm/leg blood pressure gradient at rest, as well as (1) a normal exercise test with no significant dilation of the ascending aorta (z score < 3.0), (2) no aneurysm at the site of coarctation intervention, and (3) no significant concomitant aortic valve disease, may be considered for participation in competitive sports, but with the exception of high-intensity static exercise (classes IIIA, IIIB, and IIIC), as well as sports that pose a danger of bodily collision."

May consider sports except high-intensity static exercise (IIIA, IIIB, IIIC) and those where danger of collision

(Class IIb Recommendation; Level of Evidence C)

Aortic dilation or aneurysm

"Athletes with evidence of significant aortic dilation or aneurysm formation (not yet at a size to need surgical repair) may be considered for participation only in low-intensity (classes IA and IB) sports."

If not yet requiring additional surgical repair, may consider Class IA sports (Bowling, Cricket, Curling, Golf, Riflery, Yoga) or IB sports (Baseball/softball, Fencing, Table tennis, Volleyball)

(Class IIb Recommendation; Level of Evidence C)