Page 13 - Heart Failure Guidelines
P. 13

Pediatric Heart Failure Guidelines

               cautiously considered for adolescent heart failure patients who have congestive symptoms that
               are not responsive to aggressive diuretics and will not interfere with delivering proper nutrition.


               It is recognized that exercise has benefits in heart failure patients and in general should be
               encouraged. There is clearly a difference between recreational and competitive exercise. For
               recreational exercise the patient and provider should arrive at a reasonable decision together.
               Different sporting activities have been categorized to assist risk-benefit decisions:

               For competitive sports the AHA/ACC scientific statement on Competitive Athletes with
               Cardiovascular Abnormalities should be followed. General considerations were published
               (Maron et al PMID: 26621642) with recommendations for individual cardiomyopathies and
               myocarditis (Maron et al. PMID: 26542657) and heart failure in CHD (Van Hare et al PMID:
               26621645).  As with all guidelines the AHA/ACC scientific statement included the caveat, “It is
               also important to underscore that the recommendations in this AHA/ACC document are not
               intended to establish absolute mandates or the general medical (and legal) standard of care
               applicable to all cases. These recommendations do not (and cannot) absolutely and arbitrarily
               replace individual clinical judgment and informed medical reasoning.”

               Updated 4/22/2019                                                                      page 13
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