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

In the 42nd minute of a match at the 2020 European Championships in Copenhagen, 29-year-old Danish footballer Christian Eriksen fell to the ground after receiving a throw.

As medical staff rushed to the field to administer defibrillation, teammates gathered around to keep Eriksen out of sight of nearly 14,000 fans in attendance.

Ambulances probably saved Eriksen’s life. Studies consistently show that more than half of athletes who experience a sudden cardiac arrest, often mistakenly called a heart attack, die before arriving or being discharged from the hospital.

Sudden cardiac arrest is not unique to football. Even though he is rarely, every year there are reports of sudden death of amateurs or professional athletes in sports such as hockey, basketball or football. IN most casessudden cardiac death is associated with heart defects present from birth.

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

It is rare for athletes to develop cardiac arrest. Congenital heart disease or heart disease present from birth are most often cause in athletes under 35 years. In older athletes, most sudden cardiac deaths are due to coronary artery disease.

Congenital conditions

Researchers believe that most often Congenital heart disease that leads to cardiac arrest in athletes in the United States are:

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

There is some debate about whether HCM is indeed the most common cause.

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

Researchers found definitive evidence for HCM in only 8 percent of cases, compared with 30 to 40 percent in previous studies.

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

Advanced cardiomyopathy and Brugada syndrome can also be acquired conditions.

Acquire conditions

Acquired conditions are those that develop throughout your life.

IN most often The cause of sudden cardiac arrest in athletes over the age of 35 is atherosclerosis, which is a buildup of plaque in the arteries. 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 depending on the athlete’s definition and whether the studies include non-sporting cardiac events. They vary everywhere from 1 in 3,000 to 1 in 1 million.

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

IN study for 2020researchers looked at how common sudden cardiac arrest is in high 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 led to death. More than 80 percent of the people are men, and the average age was 16.6 years.

Cardiac arrest in sports

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

How best to prevent sudden cardiac arrest in athletes is still a question significant debate. Guidelines and laws vary from country to country.

IN American College of Cardiology and American Heart Association (AHA) recommend screening by reviewing your medical history and performing a physical examination.

Researchers continue to discuss the use of electrocardiogram (ECG) screening, as is being done in some countries. An ECG is a device that measures the activity of your heart.

Since 1982, Italian law requires screening before participating in an ECG for competitive sports practice. But this screening is not uniformly accepted by the international scientific community.

In Italy, the most common cause of sudden cardiac death in athletes is arrhythmogenic right ventricular cardiomyopathy. Some researchers argue that an ECG is not needed in the United States, where HCM may be the most common cause of sudden cardiac death.

Researchers continue to explore the potential usefulness of genetic tests.

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

Advantages of having a sports training and defibrillator on site

Having a certified athletic trainer and defibrillator on site is associated with a much higher chance of surviving a sudden cardiac arrest.

IN study from 2019, the researchers found that the overall survival rate among athletes who had sudden cardiac arrest was 48 percent. However, if a certified athletic trainer is present and involved in resuscitation, survival increases to 83 percent. It increased to 89 percent with the use of an automated external defibrillator on site.

Careful evaluation by a medical professional is required before you can return to the sport. Research of AHA found evidence that athletes with genetic heart disease can remain competitive at a relatively low incidence of cardiac events.

In some cases, a safe return may not be possible. Your team or institution may also disqualify you due to concerns about responsibility.

Eriksen returned to football 8 months after his sudden cardiac arrest. His doctors installed an implantable cardioverter defibrillator. However, the Italian medical authorities banned him from playing in Italy with his club team Inter Milan, which forced 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 a coronary artery disease.

Sudden cardiac death is rare in athletes and there is still debate about how best to investigate risk factors.

If you have a heart problem, you can talk to your doctor about whether it is safe for you to exercise and whether you need to have additional tests.

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