Sudden Cardiac Arrest (SCA) in athletes aged under 35 is mostly caused by an underlying genetic heart condition or disorder. Up to half of these events will appear structurally normal during an autopsy examination.
Intense physical activity can lead to changes in the heart and pathological changes to the heart can mimic genetic heart conditions’ characteristics.
Increased education and awareness of cardiac arrest, with training in resuscitation and more accessible defibrillators can all help to prevent deaths both on and off the sports pitch.
Professional footballers are in the list of victims of cardiac arrest. The trigger for the event usually occurs during training or competition. Participants in ice hockey, basketball and American football are also likely to be affected by this condition as they are particularly strenuous sports. The likelihood too, is that the casualty will be male.
Though most cases are caused by congenital conditions or cardio vascular disease, athletes do have the risk of suffering from Commotio Cordis. With this condition, the heart structure is normal, but a loss of the heart’s rhythm can occur, caused by an accident to the chest. A blow at the right moment to the chest’s electrical rhythm can prove fatal. Sudden cardiac arrest can occur up to 4 days later after the impact was made. Defibrillation and CPR needs to be performed quickly if this condition presents itself.
There is ongoing debate worldwide regarding the implementation and the extent of screening needed of athletes and their hearts. The main issues are:
- The balance of the lives saved to the number of athletes tested
- The psychological issues
- The ethical considerations
- The economic cost
In a few parts of Europe and in Israel, ECG’s are performed routinely on young athletes. The test is also recommended by the European Society of Cardiology, The International Olympic Committee and FIFA.
However, a European study into electrocardiograph screening of young athletes found that the test results were difficult to interpret even for highly experienced cardiologists.
In the United States of America, they do not recommend this way of screening athletes who are high school or college age, as long as the person appears healthy.
The reason behind this policy is that there is a belief that too often it can cause false alarms which prompt unnecessary further testing and the requirement for unproven and potentially dangerous medical investigations. It results in athletes quitting their sport needlessly. Additionally, there is no proof that has been gathered that shows it saves lives.
Instead, in America, they suggest a recommended healthcare professional 14-point checklist to screen for heart disease.
Possibly the most well known case of a sudden cardiac arrest in the UK in recent years. He collapsed whilst playing for Bolton Wanderers and was without a heart beat for 78 minutes. Thanks to the actions of staff and a doctor at the stadium he managed to pull through and you can read more about him here.
Sports under 23 coach Ugochuku collapsed during a training session at Tottenham’s training ground. He was in his third season with the club and was 44 years old. Previously in his career he played for Aston Villa, Sheffield United and England. His final years of playing had been plagued by knee injury.
When his cardiac arrest occurred, Ugo had received medical assistance and was then taken to hospital by ambulance. Sadly, he died on the 21st April 2017, leaving behind his wife Gemma and a family.
A Cameroonian international footballer who played in France’s Division 1 and England’s Premier league. He played for West Ham United and was loaned to Manchester City for a period of time.
Marc suffered his cardiac arrest during an international competitive match in Lyon, France, on the 26th June 2003, aged 28 years.
During the 72nd minute of the game, he collapsed in the centre circle. Attempts were made to resuscitate him on the pitch and he was then removed by stretcher. More resuscitation attempts were made and medics spent 45 minutes trying to restart his heart without success.
Associated with Tottenham Hotspur from 11 years old, Radwan Hamed signed as a professional aged 17. Three days after signing he went into cardiac arrest. The event happened during a match in Belgium on the 4th August 2006. He survived but was left with catastrophic brain injuries.
During assessments pre-match, the medical professional team for Spurs, declared the player had no risk of suffering an adverse cardiac event. This diagnosis was made, even though a scan had shown his heart was unequivocally abnormal.
Bystanders gave him resuscitation, but an ambulance crew did not arrive for 16 minutes. During this time, his brain was starved of oxygen.
Radwan is now supported by a carer. He has no short- term memory, his vision is very limited as is his speech. He is also unable to walk. Gruelling sessions with specialists has given him back some mobility though he cannot leave home without assistance.
His family battled in court for ten years against Tottenham Hotspur for compensation and recognition of neglect. In 2016, Radwan was finally awarded £7m to pay for his care in the future. Tottenham Hotspur were found 70 percent liable and the FA Cardiologist the remaining 30 percent.
His family now campaign for every football ground to have a defibrillator on site.
3rd May 2015 during the first four minutes of a match for Keighley rugby club against the London Skolars. Danny Jones, their half-back, had to be substituted after he became unwell. Shortly afterwards, he had a cardiac arrest and died. He was only twenty -nine years old.
On collapsing, he had been treated by the match doctor and had been taken to London’s Royal Free hospital by air ambulance. Extensive efforts were made to resuscitate him. A post mortem revealed that his cardiac arrest was caused by a hereditary heart disease that had gone undiagnosed.
Jones was described as a “popular and talented rugby league player.”
He played at the highest level for the Wales national team, playing in the 2013 Rugby League World Cup. He had spent over twelve seasons with his club, Keighley Cougars and Halifax.
He left behind his wife Lizzie, a singer who performed Danny Boy at the BBC Sports Personality of The Year Awards in 2015, and five-month-old twins.