Over the past two decades, improvements in diagnostic and surgical techniques have dramatically altered the outlook for children with congenital heart defects. Even with complex lesions, most of these children are now surviving to an age were issues of exercise and sports participation must be considered. In this review, the various factors that affect cardiovascular performance during exercise are examined in terms of how they relate to different types of congenital heart defects. The effect of anatomy, myocardial stress, and associated noncardiac abnormalities are discussed. Exercise performance in the major classes of cardiac defects and factors limiting performance in these classes are reviewed.
S.M. Paridon Is with The Children’s Hospital of Philadelphia, Division of Cardiology, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104.