<s>[INST] hi doc...im 17 years old and we have a swimming subject in our physical education..i had a rheumatic fever...and i had also my maintenance medicine...the size of the hole is just like a rice pellet..is it advisable for me to have a swimming class...?than you [/INST] Dear Friend. Welcome to Chat Doctor. I am Chat Doctor. I understand your concern. Swimming can cause ENT infections specially ear infections. If you have valvular problems you are prone to develop infective endocarditis. So, you should avoid swimming. Moreover, if you have breathing difficulties, swimming should be done under care and guidance. This is my personal opinion for you based on available details. If you have any further query please ask me. Stay HealthyChatDoctor, MD </s>