Psychological impact of sports restriction in asymptomatic adolescents with hypertrophic cardiomyopathy, dilated cardiomyopathy, and long QT syndrome

Adolescents with cardiomyopathy and arrhythmia syndromes are at increased risk for sudden death. As such, adolescents with these conditions are often restricted from participation in competitive sports despite the absence of exertional symptoms. Many studies have reported the psychological impact of cardiovascular disease in symptomatic patients, such as those with heart failure or internal defibrillators. However, there are few studies investigating the impact of sports restrictions on asymptomatic adolescents with cardiac conditions. This is a prospective cross-sectional study examining the psychological impact of sports restriction on asymptomatic adolescents with cardiomyopathy or long QT syndrome. Among 30 eligible adolescents aged 12-18 years who had dilated cardiomyopathy, hypertrophic cardiomyopathy, or long QT syndrome and were asymptomatic, 12 (40%) completed the survey. The questionnaires included scale-based questions as well as open-ended questions related to quality of life, anxiety, and identity development. Survey responses were analyzed according to the level of adherence to the sports restrictions: 8 who adhered always or almost always were compared to 4 patients who were less adherent. While there was no statistical difference in quality of life, anxiety, or identity development scores between those who adhered versus those who did not, our sample size was small. We did find a trend toward greater anxiety in those who adhered to the restrictions. This finding deserves further investigation into the association between anxiety and sports restriction. Additionally, studies examining the overall prevalence of anxiety in this population are needed for better anticipatory guidance and psychological intervention for adolescents with these conditions.