Valvular Heart Disease in Athletes

Purpose of Review Valvular heart disease is prevalent in older athletes with primarily degenerative valvular disorders and younger athletes with congenital or genetic syndromes. Limited data exist on the risks and benefits of exercise for athletes with underlying valvular disorders, so current guidelines are primarily based upon expert consensus. This review focuses on the current data, guideline recommendations, and emerging clinical conundrums for athletes with common valvular heart conditions including aortic stenosis, bicuspid aortic valve (BAV), mitral regurgitation (MR), mitral valve prolapse (MVP), and thoracic aortic aneurysms. Recent Findings Aortic growth appears similar in athletes compared to non-athletes with BAV. Return to exercise following mitral valve repair for primary MR does not seem to lead to significant valve deterioration or adverse outcomes in short-term follow-up. Longitudinal cohort studies of athletes with MVP have suggested that ventricular arrhythmias can be common, but sudden cardiac death is rare. Aortic dilation is uncommon in young otherwise healthy athletes, but can commonly be found in older endurance and strength athletes.SummaryValvular heart conditions in athletes are prevalent in clinical practice; however, there are limited data on the outcomes in these patients to drive guideline development and clinical decision-making. Future research should focus on defining the risks of continual exercise on outcomes in patients with known valvular disease, the optimal time for valve repair/replacement, and the risks of returning to exercise following valvular intervention.

Automated summary

Valvular heart disease is common in athletes, but there is limited data on outcomes. Future research should focus on assessing the impact of exercise on patients with valvular disease, optimal timing for valve repair/replacement, and risks of returning to exercise post-intervention.