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Sports_Marfan_Overview.html
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Sports_Marfan_Overview.html
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<!DOCTYPE html>
<html lang="en">
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<meta name="viewport" content="width=device-width, initial-scale=1" />
<head>
<meta charset="UTF-8">
<title>CardioRef: AHA/ACC 2015 Sports Participation Selector Guide: Marfan Syndrome</title>
<link rel="stylesheet" href="css/sports_answer_combined.css">
<style>
div{
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<body>
<div class="topbar">
<a href="index.html">Pedi CardioRef</a>
<div class="guidelinebar">
<a target="_blank" rel="noopener noreferrer" href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000243">
Reference: ACC/AHA Sports Participation Recommendations (Circulation 2015)
Task Force 7: Aortic Diseases, Including Marfan Syndrome</a>
</div>
</div>
<section style="margin:10px">
<p class="topspace"></p>
<label><b>By the ACC/AHA 2015 guidelines, should my patient with</label>
<select name="disease" id="dz" class="InputBox" onChange="goThere();">
<option value="">*Select Disease*</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HCM">Hypertrophic Cardiomyopathy </option>
<option value="LVNC">Left Ventricular Non-Compaction </option>
<option value="DilRestr">Dilated or Restrictive Cardiomyopathy </option>
<option value="ARVC">Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) </option>
<option value="Myo">Myocarditis </option>
<option value="Peri">Pericarditis </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="ASDVSDPDA">ASD, VSD, or PDA </option>
<option value="PS">Pulmonic Stenosis </option>
<option value="AS">Aortic Stenosis </option>
<option value="Coarct">Coarctation </option>
<option value="Cyan">Cyanotic Heart Disease, unrepaired or with palliative shunt </option>
<option value="TOF">Tetralogy of Fallot, s/p repair </option>
<option value="TGA_Must">d-transposition (d-TGA), s/p atrial switch (Mustard/Senning)</option>
<option value="TGA_Art">d-transposition (d-TGA), s/p arterial switch </option>
<option value="CCTGA">Congenitally-corrected TGA (CC-TGA, L-TGA)</option>
<option value="Fontan">Fontan </option>
<option value="Ebstein">Ebstein Anomaly </option>
<option value="AnomCoronary">Anomalous Coronary Artery Origin</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="PVR">Elevated PVR in CHD </option>
<option value="VentricularDysfxn">Ventricular Dysfunction s/p CHD Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Valve_AS">Aortic Stenosis</option>
<option value="Valve_AR">Aortic Regurgitation </option>
<option value="Valve_MS">Mitral Stenosis</option>
<option value="Valve_MR">Mitral Regurgitation </option>
<option value="Valve_Hx">History of Mitral or Aortic Valve Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HTN">Hypertension </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="AoDiseases_and_Marfan">Aortic Diseases and Marfan Syndrome</option>
<option value="BAV">Bicuspid Aortic Valve</option>
<option value="Marfan">Marfan Syndrome</option>
<option value="TAA">Thoracic Aortic Aneurysm, familial or unexplained</option>
<option value="LoeysDietz_EhlersDanlos">Loeys-Dietz or vascular Ehlers-Danlos</option>
<option value="AoEnlarge">Enlarged Aorta, non-syndrome non-familial</option>
<option value="Ao_Surgery">S/p Surgery for Aortic Enlargement/Dissection</option>
<option value="Chronic_AoDissection">Chronic Aortic Dissection or Branch Aneurysm</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="CoronaryOverview">Coronary Artery Disease </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Syncope">Syncope </option>
<option value="Arrhythmia">Arrhythmias (SVT, PVC, Vtach, etc.) </option>
<option value="ConductionDefect">Conduction Defects (AV block, brady, pacemaker, RBBB/LBBB)</option>
<option value="Channelopathies">Channelopathies (LQTS, CPVT, Brugada, etc.) </option>
<option value="ICD">Implantable Cardioverter-Defibrillator (ICD) </option>
</select>
<span>participate in organized sports?</span></b>
<br><br>
<section id="question">
Should my patient with <b>Marfan Syndrome</b> participate in organized sports?
</section>
</section>
<!-- End of 10px margin section. Consider changing template. -->
<br>
<!-- navigation bar for disease sub-categories -->
<nav>
<a href="Sports_BAV_Overview.html">Bicuspid Aortic Valve</a>
<a href="Sports_Marfan_Overview.html" class="active">Marfan</a>
<a href="Sports_TAA_Overview.html">Familial Thoracic Aortic Aneurysm (or unexplained TAA)</a>
<a href="Sports_LoeysDietz_EhlersDanlos_Overview.html">Loeys Dietz or Ehlers Danlos</a>
<a href="Sports_AoEnlarge_Overview.html">Enlarged Aorta, without syndrome, non-familial</a>
<a href="Sports_Ao_Surgery_Overview.html">S/p Aortic Surgery</a>
<a href="Sports_Chronic_AoDissection_Overview.html">Chronic Aortic Dissection or Branch Aneurysm</a>
</nav>
<div class="largeanswerbox">
<h1 align="center">Marfan syndrome</h1>
<hr>
<section id="needtoknow">
<p class="sectiontitle">Need to perform:</p>
<p>"Athletes with Marfan syndrome should undergo echocardiographic (and in some instances MRA or CT)
measurement of the aortic root dimension every 6 to 12 months, depending on aortic size."
</p>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
</section>
<section id="answer_arrow_section">
<section class="single_invisible">⇓</section>
</section>
<section id="answer">
<section class="single_center">
<p class="sectiontitle">Participation criteria</p>
<p>
"It is reasonable for athletes with Marfan syndrome to participate in
low and moderate static/low dynamic competitive sports
(classes IA and IIA)
if they do not have ≥1 of the following:
<ul>
<li>Aortic root dilatation (ie, z score > 2, or aortic diameter >40 mm, or >2 standard deviations
from the mean relative to BSA in children or adolescents < 15 years old</li><br>
<li>Moderate to severe mitral regurgitation</li><br>
<li>Left ventricular systolic dysfunction (ejection fraction < 40%)</li><br>
<li>Family history of aortic dissection at an aortic diameter < 50 mm"</li>
</ul>
</p>
<div class="verdict_maybe"><b>Class IA and IIA = reasonable</b>, if patient has <u>none</u> of the above findings.</div>
<p class="rec_class">(Class IIa Recommendation; Level of Evidence C)</p>
<hr>
<p>
"Athletes with Marfan syndrome, familial TAA syndrome, Loeys-Dietz syndrome,
unexplained aortic aneurysm, vascular Ehlers-Danlos syndrome,
or a related aortic aneurysm disorder should <u>not</u> participate in
any competitive sports that involve intense physical exertion or the potential for bodily collision."
</p>
<div class="verdict_no"><b>No sports involving intense physical exertion or potential for bodily collision</b></div>
<p class="rec_class">(Class III Recommendation; Level of Evidence C)</p>
</section>
</section>
</div>
<p class="foot">
<b>Reference:</b> <a href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000243"><i>Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force .</a>
A Scientific Statement From the AHA and ACC. Circulation 2015</i> Task Force 7: Aortic Diseases, Including Marfan Syndrome
<br><br><b>Disclaimer:</b> 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.
</p>
<section class="key">
<p><b>Key:</b> MRA = magnetic resonance angiography, CT = computed tomography, BSA = body surface area, TAA = thoracic aortic aneurysm
</p>
</section>
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