Exercise prescription in adults with congenital heart disease: a long way to go

Objective-To determine if appropriate advice had been given to adults with congenital heart disease regarding safe and effective exercise, and to asse ss pre-existing misconceptions of the potential benefits and dangers of exe rcise. Design-An anonymous self assessment questionnaire. Setting-A tertiary referral clinic. Patients-99 adults (57 men, 42 women) with congenital heart disease, mean a ge 25.6 years. Main outcome measures-The extent and nature of exercise advice given over p revious years; a measure of current activity level compared with the Americ an Heart Association recommendations; and an assessment of exercise limitin g symptoms and a description of barriers to further exercise. Results-44% of the cohort assumed all exercise was safe despite their cardi ac disease. A health care professional had only raised the issue of specifi c exercise advice in 28 cases. Of those given instruction it was more commo n to receive prohibitive advice (30%) than to be encouraged to take more ex ercise (19%). Despite this 61% were involved in some form of at least light exercise. The most prevalent barriers to exercise were current symptoms (3 2.3%), lack of interest in exercise (24.2%), and health fears (16.1%). Conclusions-The education of adults with congenital heart disease regarding exercise and its potential benefits and limitations is suboptimal even in a specialist clinic.