Heart attacks in football and other sports: causes, perspectives, prevention

In the 42nd minute of a 2020 European Championship match in Copenhagen, 29-year-old Danish footballer Christian Eriksen collapsed after receiving a lineout.

As medical staff rushed onto the pitch to administer defibrillation, teammates gathered to protect Eriksen from the sight of nearly 14,000 fans in attendance.

Prompt emergency medical care probably saved Eriksen’s life. Education consistently show that more than half of athletes who experience sudden cardiac arrest, often mistakenly called a heart attack, die before reaching or being discharged from the hospital.

Sudden cardiac arrest isn’t just about calcium. Despite being rare, every year there are reports of amateur or professional athletes in sports such as hockey, basketball or football dying suddenly. In most of the casessudden cardiac death is linked to heart defects present from birth.

Read on as we explore why athletes develop cardiac arrest and what they can do to reduce their risk.

It is rare for athletes to develop cardiac arrest. Congenital heart conditions, or heart conditions present from birth, are the more common cause in athletes under 35. In older athletes, the majority of sudden cardiac deaths are due to coronary heart disease.

Congenital conditions

Researchers believe the more common Congenital heart conditions that lead to cardiac arrest in athletes in the United States are:

  • Hypertrophic Cardiomyopathy (HCM): a thickening of the walls of the left ventricle. HCM is believed to be the most common cause of sudden cardiac death in athletes and it affects 1 in 500 people in the general population.
  • Abnormal origin of a coronary artery: improper placement of one of the coronary arteries that supply blood to the heart.

It is debated whether HCM is indeed the most common cause.

A study 2015 examined autopsies of National Collegiate Athletic Association (NCAA) athletes who died of sudden cardiac arrest from 2003 to 2013. One in four athletes had a structurally normal heart, implying that arrhythmias or electrical disturbances may have been the cause of death the most. common.

Researchers found definitive evidence of HCM in only 8% of cases compared with 30-40% in previous studies.

Other cardiac abnormalities that can contribute to sudden cardiac death include:

Dilated cardiomyopathy and Brugada syndrome can also be acquired conditions.

Acquired conditions

Acquired conditions are those that develop over the course of your life.

The more common cause of sudden cardiac arrest in athletes over the age of 35 is atherosclerosis, which is the buildup of plaque in the artery wall. Risk factors for atherosclerosis include:

Other acquired conditions that can lead to cardiac arrest include:

Estimates of how often athletes experience sudden cardiac arrest vary by definition of athlete and whether studies include cardiac events outside of sport. They go everywhere from From 1 in 3,000 to 1 in 1 million.

A 2016 study estimates that the risk of sudden cardiac death among NCAA Division 1 athletes is 1 in 53,703 athletes per year. Certain groups of people, such as black athletes, basketball players, and males, appear to be more at risk.

In a Study 2020Researchers examined how common SCA was in middle school for professional athletes using a national surveillance program in the United States.

They identified 74 cases of sudden cardiac arrest with survival and 105 that resulted in death. More than 80% of the people were male and the average age was 16.6 years.

Sports cardiac arrest

In a Study 2021, the researchers looked at the incidence of sudden cardiac arrest in athletes aged 11 to 29 in the United States for 4 years. They identified 331 total cases.

How to best prevent sudden cardiac arrest in athletes is still a question of wide debate. The guidelines and laws vary from country to country.

The American College of Cardiology and American Heart Association (AHA) recommend screening by reviewing your medical history and doing a physical exam.

Researchers continue to discuss the implementation of screening with an electrocardiogram (ECG), as is the case in some countries. An ECG is a device that measures the activity of your heart.

Since 1982, Italian law required pre-participation screening with an ECG for competitive sports practice. But this projection has not been uniformly accepted by the international scientific community.

In Italy, the most common cause of sudden cardiac death in athletes is Arrhythmogenic cardiomyopathy of the right ventricle. Some researchers argue that ECG is unnecessary in the United States, where HCM may be the most common cause of sudden cardiac death.

Researchers are continuing to examine the potential usefulness of genetic tests.

Eating a balanced diet can help reduce the risk of coronary heart disease, especially for older athletes. Foods that reduce the risk of heart disease are also likely to support athletic performance and overall health.

Advantages of having athletic training and a defibrillator on site

Having a certified physical trainer and defibrillator in place is linked to a much higher chance of survival after sudden cardiac arrest.

In a study 2019, the researchers found that overall survival among athletes who experienced sudden cardiac arrest was 48%. However, if a certified fitness coach was present and involved in resuscitation, survival rose to 83%. It increased to 89% with the use of an on-site automated external defibrillator.

Careful evaluation by a doctor is required before you can return to sports. A study of the AHA found evidence that athletes with genetic heart disease can remain competitive with a reasonably low incidence of cardiac events.

In some cases, it may not be possible to return safely. Your team or institution may also disqualify you for liability issues.

Eriksen returned to football 8 months after his sudden cardiac arrest. Doctors provided him with an implantable cardioverter defibrillator. However, Italian medical authorities banned him from playing in Italy with his club side, Inter Milan, leading him to sign with Brentford in the UK Premier League.

The most common cause of sudden cardiac death in young athletes is congenital heart disease. In older athletes, it is coronary heart disease.

Sudden cardiac death is rare in athletes, and there is still debate as to how best to screen for risk factors.

If you have a known heart problem, you can speak to your doctor about whether it is safe for you to play sports and if you should undergo further tests.

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