Marfan Contact Sport Restriction — EECC MCQ

Correct answer: A — Contact sports and activities with risk of bodily collision (basketball, football, rugby, martial arts) should be avoided in Marfan syndrome — the risk of aortic injury from chest trauma combined with the underlying aortic wall vulnerability creates an unacceptable risk of traumatic aortic rupture or dissection

Exercise restrictions in Marfan per the 2020 ESC Sports Cardiology Guidelines and expert consensus: AVOID: (1) contact/collision sports (basketball, football, rugby, martial arts, boxing, hockey — risk of chest trauma to a structurally vulnerable aorta); (2) heavy isometric exercise/weightlifting (acute BP spikes increase aortic wall stress); (3) competitive high-intensity sport. PERMITTED: low-moderate intensity recreational exercise (walking, cycling, swimming at comfortable pace, golf). Basketball specifically combines: (1) frequent bodily contact (elbows, collisions); (2) high-intensity bursts (sprinting, jumping — acute haemodynamic stress); (3) competitive environment (pushing beyond safe limits). Even at 'normal' aortic dimensions, the underlying FBN1-mediated connective tissue pathology means the aortic wall is structurally vulnerable. The restrictions apply regardless of aortic size — the risk is from the underlying tissue weakness, not just the current dimension.

Reference: ESC (2020): Sports Cardiology; ESC (2024): Aortic Disease