Note: Did your patient have a mitral valve replacement, commissurotomy, or valvotomy? See also: History of Valve Intervention
Should perform:
"Athletes with MR should be evaluated annually to determine whether sports participation can continue."
(Class I Recommendation; Level of Evidence C)
"Exercise testing to at least the level of activity achieved in competition and the training regimen is useful in confirming asymptomatic status in patients with MR."
(Class I Recommendation; Level of Evidence C)
Mild-mod MR, sinus rhythm, normal LV size/function, normal PA pressures
"Athletes with mild to moderate MR who are in sinus rhythm with normal LV size and function and with normal pulmonary artery pressures (stage B) can participate in all competitive sports."
(Class I Recommendation; Level of Evidence C)
Mod MR, sinus rhythm, normal LV systolic function at rest, mild LV enlargement c/w athletic training
"It is reasonable for athletes with moderate MR in sinus rhythm with normal LV systolic function at rest and mild LV enlargement (compatible with that which may result solely from athletic training [LVEDD < 60 mm or < 35 mm/m2 in men or < 40 mm/m2 in women]) to participate in all competitive sports (stage B)."
(Class IIa Recommendation; Level of Evidence C)
Severe MR, sinus rhythm, normal LV function at rest, mild LV enlargement c/w athletic training
"Athletes with severe MR in sinus rhythm with normal LV systolic function at rest and mild LV enlargement (compatible with that which may result solely from athletic training [LVEDD < 60 mm or < 35.3 mm/m2 in men or < 40 mm/m2 in women]) can participate in low-intensity and some moderate-intensity sports (classes IA, IIA, and IB) (stage C1)."
(Class IIb Recommendation; Level of Evidence C)
Definite LV enlargement, pulmonary HTN, or LV systolic dysfunction at rest
"Athletes with MR and definite LV enlargement (LVEDD ≥65 mm or ≥35.3 mm/m2 [men] or ≥40 mm/m2 [women]), pulmonary hypertension, or any degree of LV systolic dysfunction at rest (LV ejection fraction < 60% or LVESD > 40 mm) should not participate in any competitive sports, with the possible exception of low-intensity class IA sports."
(Class III Recommendation; Level of Evidence C)
Not Recommended
Patients on long-term anticoagulation: "Athletes with a history of atrial fibrillation who are receiving long-term anticoagulation should not engage in sports involving any risk of bodily contact."
(Class III Recommendation; Level of Evidence C)
Reference:
Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities. Task Force 5: Valvular Heart Disease.
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: MR = mitral regurgitation, mod = moderate, PA = pulmonary artery, LV = left ventricle, c/w = consistent with