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Exercise and Sport Participation in Pediatric Hypertrophic Cardiomyopathy: A Changing Paradigm
William W Russell1, Jonathan B Edelson1
1Department of Pediatric Cardiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA.
Current Treatment Options in Cardiovascular Medicine
|August 5, 2026
Summary
Recent studies show that vigorous exercise is safe for children with hypertrophic cardiomyopathy (HCM). Guidelines now favor personalized risk assessment and shared decision-making over activity bans for pediatric HCM patients.
Area of Science:
- Cardiology
- Pediatric Medicine
- Sports Medicine
Background:
- Hypertrophic cardiomyopathy (HCM) historically led to strict exercise restrictions in children.
- Concerns about the negative impacts of physical activity (PA) bans on pediatric patients' well-being have grown.
Purpose of the Study:
- To review updated research and guidelines on exercise and sport participation for pediatric HCM patients.
- To highlight the shift from uniform restrictions to individualized approaches.
Main Methods:
- Review of recent scientific literature and clinical guidelines.
- Analysis of prospective cohort studies, including the LIVE-HCM study.
Main Results:
- Vigorous exercise did not correlate with adverse cardiac events (death, ICD shock, arrest, syncope) in pediatric HCM patients.
- Evidence suggests that restricting PA negatively affects cardiovascular health and emotional well-being in children with HCM.
Conclusions:
- Current evidence supports individualized risk assessment and shared decision-making (SDM) for pediatric HCM patients regarding PA.
- Guidelines are evolving to promote safe participation in recreational and competitive sports, moving away from blanket activity prohibitions.
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