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To the Editor:—
I wish to comment on the answer of Dwight E. Harken, M.D., to E. G. Olmstead, M.D., regarding rheumatic heart disease and sports (JAMA179:919 [March 17] 1962).This is an example of a situation in which an apparently safe, conservative course of action by the physician can do harm. The sudden prohibition of participation in strenuous activities which are part of his normal way of life will traumatize this 18-year-old boy severely. It can be justified only on a temporary basis if there is clear evidence of active rheumatic carditis. Even real aortic insufficiency which is well compensated is not a contraindication to competitive sports. In this case, we have not adequate information on which to state that there is significant aortic insufficiency (such as a statement of blood pressure). Perhaps he has a congenital bicuspid aortic valve with hardly any regurgitation, which has been
Lurie PR. Heart Disease and Sports. JAMA. 1962;181(4):354. doi:10.1001/jama.1962.03050300074028