Heart & Vascular

Congenital heart disease and exercise


October 18, 2022

Advice and myth-busting about exercising with heart disease.

If you have congenital heart disease, you may be wary of engaging in physical activity. This may be because you’ve heard outdated or incorrect advice telling you to avoid exercising with heart disease. Or you may simply be nervous that exercise will be dangerous for your heart. The truth is that people with congenital heart disease can and should enjoy physical activity after getting the OK from their doctor.

“We all know that exercise is good for you,” said Dr. Benjamin Frischhertz, a congenital heart disease specialist with the Vanderbilt Adult Congenital Heart Disease Clinic. “And the more we learn about congenital heart disease, the more we realize that exercise is good for our patients, too.”

Dr. Frischhertz said he’s seen some encouraging results with patients who engage in physical activity. “We’ve noticed that our patients who weren’t exercising get in shape and feel better after beginning to exercise,” he explained. “They’re more functional and their symptoms are less now that they’re exercising regularly.”

General recommendations for exercising with heart disease

“It’s far more important to be consistent and to get in shape than to overdo it once and then not exercise for a while after that session.”

If you haven’t been physically active, talk to your doctor before beginning a new exercise routine. Your physician may consider different types of testing before clearing you for physical activity. “Stress testing, for instance, which is running someone on a treadmill while we’re monitoring their heart, tells us how the heart does while someone is exercising,” Frischhertz said. “And that usually gives us reassurance to say, ‘Go for it.’”

If you’re already engaging in physical activity, it’s still a good idea to talk to your doctor about the types of exercise you do. “We make a pretty good habit of asking what someone’s doing, asking them if they’re exercising, and how often,” Frischhertz added. “Every now and then we might give advice, refining someone’s exercise regimen.”

Your doctor can provide information surrounding restrictions, if any. For example, some patients with aorta dilation may need to avoid heavy weightlifting.

The main recommendation Frischhertz said he gives patients, however, is to ease into it. “Lots of our patients are limited in how well they can exercise by their congenital heart disease,” he explained. “But it’s far more important to be consistent and to get in shape than to overdo it once and then not exercise for a while after that session.”

Engage in physical activity at least five days a week, he suggested. And gradually increase the time or intensity as you notice improvement.

In some cases, your physician might prescribe physical therapy or cardiac rehab. “Cardiac rehab is a way to hold ourselves accountable,” Frischhertz said. “When we’re scheduled to be somewhere, it’s easier to adhere to a regimen.” Plus, supervised sessions can also help get you more comfortable with exercise and prepare you for engaging in physical activity on your own.

For patients who’ve had the Fontan procedure

Exercise is also important for patients who’ve had a Fontan procedure, said Dr. Angela Weingarten, another congenital heart disease specialist with Vanderbilt. The Fontan procedure is performed on patients who are born with only one pumping chamber.

“The Fontan surgery reroutes the systemic venous blood back to the lungs passively without going back to the heart,” she explained. “There’s no pump pumping blood out to the lungs. The skeletal muscles, especially the legs, can serve as a pump to get blood up to the lungs more easily.” That’s why both cardio and strength training, especially strengthening the legs, is crucial.

Dr. Weingarten said patients should talk to their cardiologist about a plan for physical activity. But in general, she added, patients who’ve had the Fontan procedure are unlikely to have exercise restrictions placed on them.

Like Frischhertz, Weingarten recommends keeping it simple at first while aiming for consistency. “Go for a 10-minute walk, five days a week,” she explained. “Then in a week or two, extend the walk to 12 minutes. Build slowly on wherever you are in your fitness level.”

Exercise can help you monitor your heart

There’s another reason why Frischhertz said he recommends exercise, aside from its many health benefits. Physical activity can make you more aware of symptoms. “Exercise can be the canary in the coal mine,” he explained. “If the heart’s changing, we may notice symptoms first when we’re asking our heart to perform harder.” That doesn’t mean you should be wary of exercise, simply that if you notice you’re having increased shortness of breath while exercising or that your heart continues racing after you stop exercising, that you should report these symptoms to your doctor.

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The Vanderbilt Heart and Vascular Institute’s team treats all types of cardiovascular diseases and conditions, from the common to the complex. Vanderbilt is consistently recognized by U.S. News & World Report among the best heart hospitals in the nation and the best in Tennessee, with a wide range of services offered in convenient locations throughout the region. Call 615-322-2318.

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