Exercise in Valvular Heart Disease: Risks and Benefits

Valvular heart disease (VHD) carries documented risks for active individuals. At the same time, many individuals with intermediate degrees of valve disease can safely exercise and even participate in competitive athletics. Unfortunately for clinicians caring for these patients, data are scarce. Understanding the pathophysiology and natural history of VHD is key to applying consensus guidelines and making recommendations to individual patients. Careful physical examination and appropriate imaging studies will identify patients at risk; most will require serial evaluation but can exercise and participate in sports as desired. When symptoms develop, prompt treatment of severe, symptomatic disease and intensive cardiac rehabilitation as well as continued surveillance after surgical treatment will maximize the functional ability of active individuals with VHD.