Three teens reported physical restrictions and the reasons for this varied. For one teen, this was related to his anticoagulation therapy. He was careful vis-à-vis physical activity “[because] I can't get hit in the head” which even precluded him from swimming. He felt he could die if he hit his head in the pool, in stark contrast with another teen who took Coumadin. She was to be more careful than her peers but “I'm not really if I fall it might be a bigger bruise.” It was difficult to tease out what contributed to activity restrictions. For less-active teens lack of participation in physical activities seemed in part because of their lack of interest. Teens also associated their lack of physical activities to being “lazy.” One teen did not participate in gym class because of her “laziness” not because of her congenital heart disease. Another participated in sports when he was younger but was “lazy now” and chose not to be as physically active.