Dr. Richard Weiler, a medical sport and exercise specialist reports in the British Journal of Sports Medicine that the prevention of apparently inexplicable heart attacks amongst numerous young sportsmen and women is seriously challenged due to large gaps in basic knowledge about their causes.
Following the recent incident of premier league football player Fabrice Muamba’s collapsing on the pitch in front of a packed stadium after sustaining a sudden heart attack, Dr. Weiler and his team call to at least establish a reliable database that includes all these events across all sports in order to gain more knowledge. Dr. Weiler points out that Mr. Muamba was fortunate to recover. However, he says that incidents like these can still occur, regardless of screening programs. Even though these incidents are rare, there is little knowledge as to why they occur.
Dr. Weiler states that even though these incidents have led to better pitch-side care and improved acute sports medicine, including emergency life support, defibrillation and developing practical education courses, as well as emergency care guidelines, he states:
“We still lack many answers to basic questions about these afflictions. We do not know the exact numbers and trends in prevalence or incidence, and do not understand the [multiple causes] that trigger sudden cardiac death in previously healthy athletes.”
He continues saying that some issues, such as gender, ethnicity, geography and genes still need to be further investigated, stating that in light of recent research, which associated sudden heart attacks to sickle cell trait, Sub-Saharan Africans could potentially be a ‘cardiac hotspot.’
According to other studies, African Americans tend to have a three times higher risk of sudden cardiac death/arrest compared with their white counterparts, even though the rates vary considerably depending on the type of sport that is played. Dr. Weiler states that another study also discovered that white and black athletes have different heart tracing patterns (ECGs). However, he continues saying that it has not been established whether or not this is normal or whether this suggests a higher risk in terms of sudden cardiac death.
He adds that screening programs display a significant number of false positive results, and it remains uncertain whether screening really lowers the number of deaths, whether it is cost effective, and how abnormal findings should be managed.
He argues:
“It is vital that we start to answer these questions based on reliable science and evidence. To achieve this, we propose the collection and recording of reliable data across sport of every sudden cardiac death/arrest.”
However, he states, in order for this to happen it will require the collaboration and cooperation of sporting organizations, federations, and clubs, as well as establishing a sport specific and national database that registers these incidents. He refers to the FIFA (International Football Federation) initiative, which requires that all players undergo a medical examination before any FIFA competitions, and which includes a recently established database containing FIFA’s 208 member associations to establish a base of evidence base and to gain a better understanding of the condition.
Weiler concludes, saying:
“This is one of many efforts needed to fill knowledge gaps and enable us to mitigate the risks of sudden cardiac arrest/death.”
He stresses that it is vital to have minimum standards of pitch-side medical care across all types of sporting events.
Written By Petra Rattue