Shaun White is a 27 year old native of California who’s become equal parts snowboarder and pop celebrity. In addition to enjoying great success in the X Games, White is also the 2-time defending Olympic champion in the halfpipe event.
Interestingly, White was born with a congenital heart condition known as Tetralogy of Fallot (TOF). With this condition, there are 2 primary defects–a hole (septal defect) between the ventricles (the pumping chambers) and narrowing, or stenosis, of the pulmonary valve and trunk. The remaining features include hypertrophy, or thickening, of the right ventricle which must do extra work to pump blood through the narrowed pulmonary valve, and an “overriding” aorta that is shifted in location above the septal defect. This condition occurs in approximately 1 per 2,000 infants.
By report, White underwent 2 operations to repair this condition while he was an infant. Today, most children have a complete repair in a single operation that involves closing the septal defect and enlarging the opening at the pulmonary valve or replacing the valve altogether. Most patients do quite well after operation to repair TOF. Over the long term, these patients may develop problems, even years later, like arrhythmias or leakage of the pulmonary valve. For that reason, these patients need periodic monitoring indefinitely.
White is an example of the growing population of adult athletes who have some form of (often corrected) congenital heart disease. It’s really not surprising that there are elite athletes in this situation. In the specific case of corrected TOF with a good outcome, the most recent guidelines from the 36th Bethesda Conference suggest that athletes can participate fully in their sports. There will be specific guidelines regarding the safety of sports for each of the many different congenital heart conditions.
There is increasing awareness in the medical community of the importance of exercise for teenagers and adults who have congenital heart disease. Recent guidelines will help athletes and their doctors make thoughtful decisions about exercising safely.
Photo by http://www.flickr.com/photos/bfishadow/ User:bfishadow.