Fontan circulation - Taking risks with a Fontan circulation

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

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This information is designed for use by young people with a Fontan circulation and their families.

Being a teenager is often a time of experimentation and working out who you are as a person. It is normal to want to try new things and fit in with friends. While there are many adventures you can join in with you also need to know that some things are especially dangerous when you have a Fontan circulation.

Energy drinks

Energy drinks contain high levels of caffeine. Caffeine is commonly used to make you feel more awake and can cause your heart to beat faster. Energy drinks may cause arrhythmia or heart rhythm disturbance. People with a Fontan circulation are more at risk of developing an arrhythmia and at times this may be life threatening. Therefore if you have a Fontan circulation energy drinks should be avoided. Instead, tea and coffee have less caffeine than energy drinks and you can safely drink these on occasion.


Alcohol is dealt with by your liver as a toxic substance. Many people with a Fontan circulation can have or be more likely to develop liver problems. Drinking alcohol may lead to worsening of your heart condition, possibly interact with your medications and increase the risk of symptoms such as palpitations and impaired liver function. Alcohol might be okay in small amounts but it is important to discuss your alcohol intake with your cardiologist. Drinking frequently or to extreme is likely to be harmful to your body.


Smoking is never okay. Smoking can lead to problems such as reduced circulation, blood vessel damage and a higher risk of stroke. Smoking can also interfere with many medications. The effects of smoking will be more pronounced in people with a Fontan circulation compared to people with a normal circulation.


The term ‘drugs’ includes many things. There are over the counter medicines, prescription medication, herbal preparations and street drugs. You should always take your prescribed medications. Before you take herbal preparations you should discuss them with your cardiologist as

many can interact with your regular medications. Street drugs include things like marijuana and cocaine. You may feel pressured to try street drugs at some point. These drugs are not controlled and may be mixed with impurities such as the chemicals used in household cleaning products as well as the ingredients that cause the typical ‘high’. Street drugs can cause abnormal heart rhythms that are especially dangerous for a Fontan circulation, high blood pressure, heart attack and impaired judgment. People with a Fontan circulation are likely to be more severely effected by street drugs. The bottom line:  never take street drugs.

Piercings and tattoos

People who have a Fontan circulation may have an increased risk of bacterial endocarditis (infection in the heart) due to having artificial material within their hearts as well as having slower blood flow. Bacterial endocarditis can lead to needing more heart surgery and can be life threatening. Piercings and tattoos can be a way for bacteria to enter the blood and spread to your heart. Piercings and tattoos are okay with proper precautions taken but you should check with your cardiologist before going ahead. If you are going to get a tattoo or piercing ask people you trust about safe places to get them done. Ask the piercer or tattooist questions that assure you they are safe. Plan before going ahead to ensure your health is not affected.

You could try a henna tattoo or other non-permanent options for a bit of fun without the risk.

Questions to ask your piercer or tattooist:

  • How do you sterilise your equipment?
  • Are you using a brand new needle? (You can ask them to open the packet in front of you)
  • Can I see your license?
  • How do you stop contamination?
  • Do you have a qualification in preventing contamination?

For more information…

You should talk to your cardiologist or specialist cardiac nurse. All your conversations with medical professionals are private and confidential and you can feel comfortable to ask them about anything. As you get older your cardiologist will try and spend some time with you before your parents come into the appointment as well, this can be a good time to ask questions if you do not want to ask in front of your parents. 

The Children's Hospital at Westmead

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