Can they play games? – Cleveland Clinic

For many children, sports are an integral part of their childhood and adolescence. However, when children live with or develop heart problems, parents worry about how safe it can be for them to play sports.

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Pediatrician/electrophysiologist Akash Patel, MD, says there are many factors that determine whether a child can (or can’t) play a particular sport.

“We’ve learned that creating a proper safety net for kids can make us more generous in allowing them to participate in sports,” he says. “Of course, there are unique situations where we want children to avoid playing certain types of sports, or can adapt the sports environment to be as safe as possible. But the goal is for the majority of children to be able to play sports safely.

Can children with heart problems play sports?

Dr. Patel says that participation in sports usually depends on the child’s particular heart condition. Every child is different – ​​and even children with the same diagnosis may have different symptoms or a more severe form of the condition.

Take cardiomyopathy, or conditions that affect the heart muscle. With these, your heart may become hard, have scar tissue, or become enlarged or enlarged.

“We know that when people living with this diagnosis play sports, they are at risk of sudden cardiac arrest during the activity,” Dr. Hypertrophic cardiomyopathy, which refers to thickening of the heart muscle, says Patel. The “most relevant” type where sports are concerned.

“But not all children diagnosed with cardiomyopathy are the same. So, there are situations where they may be able to play certain types of sports or do certain levels of activity.”

In general, children who have had a heart attack, and perhaps even had heart surgery, do not need any additional protective gear for the sports they are playing. They are also generally not barred from playing certain positions – for example, are allowed to be catcher, but not first baseman in baseball.

But Dr. Patel says some kids can’t give the green light for every game. “We usually tell kids with pacemakers or defibrillators to avoid contact sports,” says Dr. Patel. “Those are the games where they can get a direct hit to a device implanted under their skin, in their stomach or chest. You want to minimize any risk of damage to these devices. It changes the games they can play.”

Guidelines for those who cannot play sports may also change over time. For example, historically, children with hereditary arrhythmias, or irregular heartbeats, were banned from playing sports. Today, however, this is not always the case.

Precautions to be taken before playing sports

All this being said, Dr Patel says there are precautions that parents, children, schools and doctors can discuss before starting to play sports. “We want to identify children who may be at risk for cardiac events on the sports field,” he says. “And we want to identify them before that happens.”

Pre-participation cardiac screening

One of the most important steps children can take besides a physical is a pre-participation cardiac screening. For athletes with a diagnosed heart condition, this screening is usually done in conjunction with a cardiologist and primary care provider.

“There we will often determine specifics in terms of what sports they can play, how they play, when and how they should limit themselves, and any kind of safety net they need to play the sport,” explains Dr. Patel. “A cardiologist will work with the primary care provider because we are focused on the heart. We can say, ‘From a cardiac standpoint, these are the things that will allow the child to return to sports.’

This screening is important because sometimes athletes die after experiencing a sudden cardiac arrest. These tragic events are rare, occurring anywhere between 1 in 50,000 to 1 in 300,000 people, but do occur.

“Unfortunately, there are situations where, despite the best screening, these events can still occur,” says Dr Patel. “An important thing that families always have to keep in mind is, ‘How do we create a safe environment if a child is going to have an event?'”

Cardiopulmonary Resuscitation (CPR)

Another layer of protection for children with heart disease is to be around people who know CPR. “Knowing CPR is a good life skill that anyone should have,” advises Dr. Patel. “But I tell families with children in cardiac arrest that all the people caring for the child — for example, parents, babies and nannies — should learn CPR.”

For athletes with heart conditions, families can take extra steps and make sure that athletic coaches and trainers are also trained in CPR. “If a cardiac event occurs, they can provide CPR until emergency services arrive and, hopefully, resuscitate that 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 return the heart to a normal rhythm.

“You should always do CPR,” says Dr. Patel. “It takes priority. But if you want to get a baby out of a dangerous situation because of an abnormal heartbeat, it’s extremely important to use an AED quickly. The sooner you can do that, the sooner you can save the baby.”

When you call 911, the police, fire department or EMS will bring a defibrillator to the scene. But today, more and more schools have AEDs available on site.

“If you have kids who play sports, you might want to ask if your school has an AED available—and if so, if it’s related to the sports field,” suggests Dr. Patel. When schools cannot provide an AED, families can buy their own. “It’s not necessary for healthy kids,” he continues, “but it’s something that’s been shown to provide benefits for at-risk kids.”

For example, children with a condition called Long QT syndrome, which affects the heart’s electrical system, should have an AED nearby. “If we know they’re on appropriate medication, and their ECG suggests they have low-risk characteristics, we can allow them to play,” says Dr Patel. “But then they need to have AEDs available at sporting events and people around know how to do CPR.”

At the end of the day, the decision to play sports (or not) is a shared decision between the family, the child, and their doctors and other health professionals.

“This means that the parent and the child are making this decision with the school or the team and the therapist,” says Dr. Patel. “We need to create an environment where they are on the appropriate medication, care providers or coaches or parents know how to give CPR. And obviously, we assess that their situation is low risk.

“Sports offer many benefits in terms of socio-emotional development, teamwork and just pure enjoyment,” he adds. “And so our job is to make sure kids can play sports safely. If they’ve gone through an evaluation that shows they don’t have any concerns, they’re usually allowed to play any sport.”

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