Marfan – exercise restriction — RACP Paediatrics MCQ
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Correct answer: D — Recommend moderate recreational exercise and avoid competitive basketball
Explanation lettering: D = shown as A · E = shown as C · C = shown as D · A = shown as E
C is correct because for children over 10 with an aortic-root Z-score at least 3, current guidance limits skill, mixed and endurance activity to moderate recreational intensity after individual assessment; competitive basketball adds dynamic load and contact. A ignores absolute aortic size and phenotype. B is unnecessarily restrictive and sacrifices the benefits of safe activity. D does not neutralise aortic wall risk or make competition automatically safe. E cannot replace serial aortic imaging. This European paediatric aortopathy statement is jurisdiction-neutral, contemporary and applicable to Australian specialist counselling.
Reference: Cardiac Society of Australia and New Zealand, inherited aortopathies including Marfan syndrome: https://cmsuat.csanz.edu.au/wp-content/uploads/2016/11/Inherited_aortopathies_inc_Marfan_Syndrome_ratified_25-Nov-2016.pdf; 2024 joint paediatric statement, aortic disease in FBN1-related Marfan syndrome: https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/09/16/16/44/management-of-aortic-disease