World Heart Day Q&A with Stanford Children’s Heart Doctors

Exercise and Heart Disease in Kids

Ever wonder if your child with heart disease should exercise? And if so, how much and how intensely? On World Heart Day, we asked four of our pediatric cardiologists to answer these questions and others from parents who wanted to know the guidelines around exercise for their child with heart disease.

For our Ask Me Anything event on September 29, pediatric cardiologists Meaghan Beattie, MD, Michelle Kaplinski, MD, Seda Tierney, MD, and Inger Olson, MD, fielded live questions from parents. Here are some of the questions parents asked, with our team’s answers.

Q: Is exercising safe for children and young adults living with heart disease?

Yes, exercise is not only safe but beneficial for children and young adults with heart disease. There are types of congenital and acquired heart disease where certain forms of exercise may not be recommended; however, in the vast majority of cases, some form of exercise is encouraged. It’s always a good idea to check with your child’s cardiologist before starting a new exercise program.

Q: Is exercising with heart disease accepted by the medical community at large?

In the past, medical providers were much more likely to restrict exercising for kids with heart disease; however, we now recognize the many benefits of regular exercise. The risks of a sedentary lifestyle far outweigh the potential risks of exercise for the vast majority of children with heart issues.

Q: What types of exercise can a child with heart disease do, and which should they avoid?

For the majority of young children with heart disease, recreational play is not restricted. They can try both moderate and vigorous exercises. Moderate exercises include brisk walking, dancing, biking, and recreational swimming. Vigorous exercises include swimming laps, running, tennis, and jumping rope. Most importantly, find an exercise that your child enjoys doing. With some heart conditions, your child’s cardiologist may recommend avoiding heavy weightlifting or contact sports, so always check with your cardiologist before starting your child in a new sport or exercise program.

Q. How long should my child with heart disease exercise each day?

The American Heart Association recommends that all children ages 6 and older get at least an hour of moderate to vigorous exercise each day. This recommendation is the same for children with heart disease.

Q. What are the advantages of exercise for the heart, in general?

The heart is a muscle, so it benefits from regular exercise. Regular exercise in childhood can prevent your child from developing heart disease as an adult. Staying active is part of a healthy lifestyle that decreases your child’s risk of acquiring chronic health conditions like diabetes, hypertension, obesity, and coronary artery disease as he or she ages. Besides physical benefits, regular exercise also increases kids’ confidence, improves mental health, increases agility, and enables children to participate more fully in activities with their peers.

Q: What is a good target heart rate for children with heart disease while exercising?

It varies from child to child because each child’s target heart rate depends on their resting heart rate and severity of heart disease. For patients in our outpatient cardiac fitness program, Young Hearts in Motion at Stanford Medicine Children’s Health (details below), we use a tool to determine the safe target heart rate range during exercise. Ask your child’s cardiologist if he or she has concerns about your child’s heart rhythm or rate, and talk about the types of recommended exercise.

Q: Are there any studies that support exercising with heart disease?

There are countless studies demonstrating the safety and benefit of exercise in children with heart disease. Check out the guidelines from the American Heart Association, which discuss the different types of congenital heart disease and recommendations for exercise. Another resource is healthychildren.org, a website from the American Academy of Pediatrics, which has a section on benefits and recommendations for exercise with congenital heart disease.

Q: In what new ways is Stanford Medicine Children’s Health helping kids with heart disease to live a more active life?

We have an exciting new program at Stanford Children’s Health for our current heart patients called Young Hearts in Motion, which promotes fitness and a healthy lifestyle. Our objective is to help our young patients with congenital heart disease to become more active, with three months of guided one-on-one workout sessions with an exercise specialist. A pediatric cardiologist works collaboratively with other team members of the Young Hearts in Motion Program to help ensure that the exercise intensity for each participant is tailored to their fitness level and the severity of their heart disease. We assess our young heart patients’ progress throughout the program and set new goals as their fitness improves. To maintain an active and healthy lifestyle for our heart patients after the guided sessions end, graduates of our program work with a Stanford Children’s exercise specialist to develop a long-term fitness plan for continued success.