Can They Play Sports? – Cleveland Clinic
For many children, sport is an integral part of their childhood and adolescence. However, when children are living with or developing heart disease, parents are understandably concerned about how safe it might be for them to play sports.
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Pediatric cardiologist/electrophysiologist Akash Patel, MD, says many factors go into deciding whether a child can (or cannot) play a particular sport.
“We’ve learned that providing a proper safety net for children often allows us to be more liberal about participating in sports,” he says. “Of course there are special circumstances where we would like children to avoid certain sports or design the sporting environment to be as safe as possible. But the goal is that most children can play sports safely.”
Can children with heart disease play sports?
dr Patel says that participation in sports generally depends on the specific heart condition a child is living with. Every child is different – and even children with the same diagnosis may have different symptoms or a more serious form of the disease.
Take cardiomyopathy, or diseases that affect the heart muscle. As a result, your heart may be stiff, have scar tissue, or become enlarged or thickened.
“We know that people with this diagnosis who exercise are at an increased risk of experiencing sudden cardiac arrest during activity,” says Dr. Patel ‘most worrying’ guy when it comes to sports.
“But not all children with a cardiomyopathy diagnosis may be the same. So there are circumstances where they can play certain sports or engage in certain levels of activity.”
In general, children who have had heart problems and may even have had heart surgery do not need additional protective equipment for the sport they play. They are also not usually restricted from playing certain positions – for example, they are allowed to be a catcher but not a first baseman in baseball.
But dr Patel says certain kids may not be given the green light for every sport. “We generally advise children with pacemakers or defibrillators to avoid contact sports,” says Dr. patel “These are sports where there can be a direct blow to equipment implanted under the skin, in the abdomen or in the chest. You want to minimize the risk of damaging these devices. It changes the sports they can do.”
Policies about who is not allowed to play sports can also change over time. For example, children with hereditary arrhythmias or an irregular heartbeat in the past were not allowed to play sports. Today, however, that is not always the case.
Precautions before sport
Despite all this, says Dr. Patel that there are precautions that parents, children, schools and doctors can discuss before starting the sport. “We want to identify children who are at risk of having a worrying cardiac event on the sports field,” he explains. “And we want to identify them before this event occurs.”
Cardiac screening prior to participation
One of the most important steps children can take is a pre-participation cardiac exam in addition to a physical exam. For athletes with a diagnosed heart condition, this screening is generally done in conjunction with a cardiologist and a general practitioner.
“Here we often dictate certain things, what sports they can play, how they should play, when and how they should limit themselves, and any kind of safety net they need around playing sports,” explains Dr. patel “A cardiologist would work with the GP because we focus on the heart. We can say, ‘From the perspective of the heart, these are the things that would allow a child to play sports again.’”
This screening is important because there are times when athletes die from sudden cardiac arrest. These tragic events are rare, affecting between 1 in 50,000 and 1 in 300,000 people, but they do happen.
“Unfortunately, there are situations where these events can still occur despite the best screening,” says Dr. patel “One of the most important things that families should always keep in mind is, ‘How do we create the safest environment when a child has an event?'”
Cardiopulmonary resuscitation (CPR)
Another level of protection for children with heart problems is dealing with people who are knowledgeable about CPR. “Knowing CPR is a good life skill that everyone should have,” advises Dr. patel “But I say to families who have children with heart problems that everyone who cares for a child – for example, parents, babysitters and nannies – should learn CPR.”
For athletes with heart problems, families can take an extra step and ensure that athletic trainers and coaches are also trained in CPR. “If a cardiac event occurs, they can provide CPR until EMS arrive and hopefully resuscitate the child,” says Dr. patel
Automated External Defibrillator (AED)
In some cases, children may have a cardiac event where their heart rhythm becomes abnormal and dangerous. Using an AED or automated external defibrillator can help get the heart back to its normal rhythm.
“You should always do CPR,” says Dr. patel “That has priority. However, when you want to get a child out of danger due to an abnormal heartbeat, prompt deployment of an AED is crucial. The sooner you do that, the faster you can save a child.”
When you call 911, the police, fire department, or ambulance will bring a defibrillator to the scene. But today more and more schools have AEDs available on-site.
“If you have children who play sports, you should find out if your school has an AED available — and if so, where it ranks in relation to the athletic facilities,” suggests Dr. Patel in front. If schools cannot provide the AED, families can purchase one themselves. “It’s not needed for healthy children,” he continues, “but it’s something that has been shown to be beneficial for vulnerable children.”
For example, children with a condition called long QT syndrome, which affects the heart’s electrical system, should be near an AED. “We know that if they are on appropriate medication and their EKG suggests they have low-risk features, we can allow them to exercise,” says Dr. patel “But then they need to have an AED available at sporting events and people around know how to do CPR.”
Ultimately, the decision to exercise (or not) is a shared decision between a family, a child, and their doctors and other health professionals.
“That means parents and a child make that decision with the school or team and doctors,” says Dr. patel “We need to create an environment where they take the appropriate medication, where the caregivers or the coaches or the parents know how to do CPR. And clearly we assess that her condition poses a low risk.
“Sport offers many benefits in terms of social-emotional development, teamwork and just pure joy,” he adds. “That is why it is our job to ensure that children can play sports safely. If they have undergone an assessment that shows there is no concern, they are often allowed to play any sport.”