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

In the 42nd minute of the 2020 European Championship match in Copenhagen, the 29-year-old Danish football player Christian Eriksen collapsed to the ground, receiving a throw-in.

As medical personnel rushed onto the pitch to perform defibrillation, teammates gathered around to shield Eriksen from the gaze of the nearly 14,000 fans present.

The prompt medical emergency likely saved Eriksen’s life. Research consistently show that more than half of athletes who experience sudden cardiac arrest, often erroneously referred to as a heart attack, die before reaching or leaving the hospital.

Sudden cardiac arrest is not unique to football. Although rare, every year there are reports of sudden death of amateur or professional athletes involved in hockey, basketball or football. AT most casessudden cardiac death is associated with heart defects present from birth.

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

Athletes rarely go into cardiac arrest. Congenital heart defects or heart defects present at birth are most common cause in athletes under 35 years of age. In older athletes, most cases of sudden cardiac death are associated with coronary heart disease.

congenital conditions

Researchers believe that most common Congenital heart defects that lead to cardiac arrest in athletes in the United States:

  • Hypertrophic cardiomyopathy (HCM): thickening of the walls of the left ventricle. HCM is believed to be the most common cause of sudden cardiac death in athletes and affects about 1 out of 500 person in the general population.
  • Abnormal origin of the coronary artery: an abnormal location of one of the coronary arteries that supply the heart with blood.

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

BUT 2015 study studied 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, meaning that arrhythmias or electrical disturbances may have been the most common cause of death.

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

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

Dilated cardiomyopathy and Brugada syndrome can also be acquired conditions.

Acquired Terms

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

most common The cause of sudden cardiac arrest in athletes over 35 is atherosclerosis, that is, the accumulation of plaque on the walls of 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 definition of an athlete and whether studies include non-sport cardiac events. They range from 1 in 3000 to 1 in 1 million.

BUT 2016 study The risk of sudden cardiac death among NCAA Division I athletes is estimated to be 1 in 53,703 athletes per year. Certain groups of people, such as black athletes, basketball players, and men, appear to be at increased risk.

AT 2020 studyresearchers studied how common high school sudden cardiac arrest is among professional athletes using a national surveillance program in the United States.

They identified 74 cases of sudden cardiac arrest with survival and 105 cases leading to death. More than 80 percent of the people were men, and the average age 16.6 years.

Cardiac arrest during sports

AT 2021 research, researchers studied the incidence of sudden cardiac arrest in athletes aged 11 to 29 in the United States over a period of 4 years. A total of 331 cases were identified.

How best to prevent sudden cardiac arrest in athletes remains an open question. serious debate. Guidelines and laws vary by country.

American College of Cardiology and American Heart Association (AHA) Recommend to be examined by examining the medical history and conducting a physical examination.

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

Since 1982, Italian law requires screening with an ECG before in-competition sports practice. But this screening was not unanimously 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 not needed in the United States, where HCM may be the most common cause of sudden cardiac death.

Researchers continue to explore potential utility genetic tests.

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

Benefits of having sports training and a defibrillator on site

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

AT 2019 studyThe researchers found that the overall survival rate among athletes who suffered sudden cardiac arrest was 48 percent. However, if a certified athletic trainer was present and involved in resuscitation, the survival rate increased to 83 percent. It increased to 89 percent using a local automated external defibrillator.

Before you can return to sports, a thorough evaluation by a healthcare professional is essential. Research conducted AHA found evidence that athletes with genetic heart disease can remain competitive with a sufficiently low rate of cardiac events.

In some cases, a secure return may not be possible. Your team or organization may also disqualify you for liability reasons.

Eriksen is back in football 8 months after sudden cardiac arrest. Doctors installed an implantable cardioverter defibrillator for him. However, the Italian medical authorities forbade him to play in Italy with his club side Inter Milan which led him to sign for Brentford in the United Kingdom Premier League.

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

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

If you have known heart problems, you can talk to your doctor about whether it’s safe for you to exercise and whether you should get further testing.

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