The heart is like a “blood pump”, through its own contraction and diastole, constantly outputting nutrient-rich blood to the organs of the body, and the first part of the blood pumped by the heart reaches the aortic root, which is therefore constantly subjected to the pressure shock from the heart pumping. Because of the congenital dysplasia of the aortic wall in patients with Marfan syndrome, the aortic root tends to dilate, and intense physical work or sports activities accelerate the rate of aortic root dilatation by promoting faster heartbeat (accelerated blood pumping) and higher blood pressure (increased pumping pressure). Therefore, in terms of delaying aortic pathology, patients with Marfan syndrome need to limit their exercise. However, “life is exercise”, and complete absence of physical activity can lead to a decrease in physical fitness and resistance, and even to such ills as Internet addiction, excessive reticence, and reduced social interaction, so the selection of the appropriate amount of exercise for patients with Marfan syndrome is a very important issue. In general, the principles should be – avoid competitive sports, excessive exercise, isotonic exercises (push-ups, weight lifting, etc.) and stressful exercises with risk of collision and fall, and appropriately engage in low and moderate intensity aerobic exercises. Suitable forms of exercise for patients with Marfan syndrome include walking or brisk walking, jogging, slow swimming, light to moderate intensity cycling, table tennis, badminton, golf, and bowling-type sports, all at a moderate pace and with some retention of physical strength. It is recommended that the frequency of exercise be increased, the duration of each exercise be shortened, and the heart rate after exercise be controlled to within 100 beats per minute (long-term use of beta-blockers such as betalactam is recommended to assist in control). For example, walking and cycling at moderate speed for half an hour to one hour daily; slow swimming, jogging and other moderate intensity physical activities for about ten minutes each time, several times a day. Of course, the specific program should be adjusted appropriately to the patient’s own situation. Proper exercise can increase appetite, enhance physical fitness, cultivate a positive mindset and sunny mental state, etc. These are the general principles, but they vary from patient to patient. Patients with Marfan syndrome whose ultrasound shows no lesions in the aorta yet, and who may have Marfan syndrome based on family history, genetic testing, and other physical signs throughout the body, can follow the above principles for exercise and receive regular cardiovascular ultrasound physical examinations. These patients are often adolescents and children who are attending school, and parents must communicate with the school to prevent them from participating in athletic and physical testing sports, but also to participate in moderate intensity physical activity. Patients with Marfan syndrome who have dilated aortic root lesions but have not yet reached the indication for surgery can also improve their physical fitness and increase their tolerance for future aortic surgery with appropriate exercise. However, the intensity and duration of activity should be strictly limited, and the frequency of cardiovascular ultrasound physical examinations should be increased appropriately. After aortic surgery, the remaining patients with Marfan syndrome who have a completely normal aorta can also receive moderate amounts of exercise and undergo regular post-operative review when they have taken 3-6 months to fully recover from the surgery. However, it should be noted that if you take warfarin for a long time after surgery, you need to avoid collisions, falls, etc., and be sure to wear a helmet when riding a bike. However, for patients with Marfan syndrome who are still left with residual aortic lesions after aortic surgery (such as those who have undergone aortic root aneurysm surgery and also have a temporarily untreated abdominal aortic aneurysm, or those who have aortic coarctation resulting in a tear throughout the aorta, where the surgery only dealt with the proximal portion and there is a residual aortic coarctation distally, etc.), walking or other low-intensity exercise is recommended, and moderate-intensity aerobic exercise is mostly to be avoided. As a final note, the above is for reference only, as patients with Marfan syndrome have a wide range of presentations and individual differences, consulting with an experienced specialist is the best way to find the right exercise intensity for you.