Lack of basic evidence hampering prevention of sudden heart attacks in sport

May 12, 2012, British Medical Journal

Big gaps in basic knowledge about the numbers and causes of apparently inexplicable heart attacks among young sportsmen and women are seriously hampering our ability to prevent them, says a sport and exercise medicine specialist in the British Journal of Sports Medicine.

At the very least, we need to start building reliable databases of all such events across sport, in a bid to start plugging these knowledge gaps, say Dr Richard Weiler and colleagues.

His comments come in the wake of the recent high profile case of premier league footballer, Fabrice Muamba, who collapsed on pitch, in front of a stadium packed with spectators, after sustaining a sudden .

Fortunately, Mr Muamba recovered, but cases like these, although rare, are still likely to occur despite screening programmes, and they are poorly understood, emphasises Dr Weiler.

These cases have prompted improvements in pitch-side and acute , including emergency life support, and the development of practical education courses and emergency care guidelines, says Dr Weiler.

None the less, he says: "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 in previously healthy athletes."

Issues that still need further investigation are the roles of gender and ethnicity, geography and genes, he says.

For example, Sub-Saharan Africa may be a "cardiac hotspot," with recent research linking sudden heart attacks to sickle cell trait.

Other research suggests that African Americans are three times more prone to sudden cardiac death/arrest than white athletes, although the rates vary considerably depending on the type of sport played.

And another study found that heart (ECG) tracing patterns differ between white and black athletes, although whether this is normal or indicates a higher risk for sudden cardiac death is not known, says Dr Weiler.

Screening programmes throw up a considerable number of false positive results, and it is still far from clear whether screening actually cuts the number of deaths, whether it is cost effective, and how to manage any abnormal findings, he says.

"It is vital that we start to answer these questions based on reliable science and evidence," he insists. "To achieve this, we propose the collection and recording of reliable data across sport of every sudden cardiac death/arrest," he writes.

But for this to happen, cooperation and collaboration will be needed among sporting organisations, federations, and clubs, in addition to the establishment of sport specific and national registries for these incidents, he suggests.

Dr Weiler cites a FIFA (International Football Federation) initiative. This requires a medical assessment before a match for all FIFA competitions, and includes a recently established database for all its 208 member associations in a bid to build up an evidence base and better understand the condition.

"This is one of many efforts needed to fill and enable us to mitigate the risks of sudden cardiac arrest/death," concludes Dr Weiler, adding that minimum standards of pitch-side medical care across all sports are essential.

Explore further: Cardiac pre-participation screenings too restrictive for black athletes

More information: What can we do to reduce the number of tragic cardiac events in sport? doi 10.1136/bjsports-2012-091252

Related Stories

Cardiac pre-participation screenings too restrictive for black athletes

March 26, 2012
Many athletes undergo cardiac screening to detect possible heart conditions before being allowed to participate in student or professional sports. Current European screening guidelines, which are based on data from white ...

Sharp decrease in deaths from sudden cardiac arrest

November 23, 2011
Only a few decades ago, sudden cardiac arrest was a death sentence. Today, a victim of sudden cardiac arrest is saved roughly once every six hours in Sweden, reveals a thesis from the Sahlgrenska Academy at the University ...

Recommended for you

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.