Exercise in Marfan Syndrome — EECC MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: C — Avoid competitive sport, heavy weightlifting, and high-intensity isometric exercise — moderate dynamic exercise (walking, cycling, swimming at recreational intensity) is permitted; the goal is to avoid sudden spikes in aortic wall stress from Valsalva manoeuvres and acute hypertension
The 2020 ESC Sports Cardiology Guidelines and Marfan expert consensus provide exercise recommendations: (1) AVOID: competitive sport (especially at high intensity), heavy weightlifting/powerlifting (Valsalva manoeuvre causes acute BP spikes and aortic wall stress), contact sports (risk of aortic rupture from chest trauma), and sports with risk of bodily collision; (2) PERMITTED: low-moderate intensity recreational exercise — brisk walking, cycling, swimming at comfortable pace, golf; (3) INDIVIDUALISED: based on aortic root size, rate of growth, family history, and genetic severity. Even at 'normal' aortic dimensions, the underlying aortic wall pathology (fibrillin-1 deficiency → elastic fibre fragmentation) means the aorta is structurally vulnerable. Regular moderate exercise is encouraged for general health and cardiovascular fitness, but intensity control is essential.
Reference: ESC (2020): Sports Cardiology Guidelines; ESC (2024): Aortic Disease