The Telegraph
Since 1st March, 1999
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Cardiac alarm for players on the pitch

Cameroon international Marc-Vivian Foe’s fatal collapse on the pitch during a Confederations Cup semifinal tie earlier this year had shocked the world. The post-mortem report of the footballer revealed sudden cardiac death (SCD).

The medical fraternity discovered Foe had been suffering from a structural heart disease, hypertrophic obstructive cardiomyopathy. And the electrolyte imbalance caused by thebout of diarrhoea and vomiting he had suffered prior to the match was enough to precipitate ventricular fibrillation, a fatal disturbance of the heart rhythm.

Cardiac specialists in the city warn Foe’s tragic and untimely demise should act as an eye-opener to our own sporting fraternity. “There is no reason to assume that high-endurance athletes at the peak of their performance, have little risk of heart ailment,” observes Debasis Mitra, consultant cardiologist, Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS).

SCD is defined as any natural death due to a cardiac cause that occurs within an hour from the onset of symptoms. “Needless to say, it is a major health hazard, especially among Indians, who are three times more prone to heart disease than their European or American counterparts,” adds Mitra.

Coronary artery disease, cardiomyopathy, congenital heart disease and arrhythmia are the major causes of SCD. The prevalence of cardiomyopathy — a disease of the heart muscle — is one in 500 and is singled out as the leading cause of SCD among high-endurance athletes below the age of 35.

Cardiomyopathy is the most commonly occurring genetically-transmitted disease and can strike anybody, say experts. “Hypertrophic cardiomyopathy, in which certain areas of the heart muscle thicken and cause difficulty in circulation, can afflict athletes too,” observes Aftab Khan, interventional cardiologist with Apollo Gleneagles Hospitals.

Excessive sweating, common after high-intensity practice, gastrointestinal upsets resulting in diarrhoea and vomiting, can alter electrolytes or body salts like sodium, potassium, magnesium, etc and precipitate serious rhythm abnormality in athletes with pre-existing heart disease. “This was most likely the contributory cause of Foe’s death,” says Mitra.

With the cardiac health of athletes the world over coming into sharp focus in the wake of Foe’s death, city doctors are advocating “effective and practical” steps to identify and treat possible heart disease among Calcutta’s youngsters into high-endurance sports.

“All players participating in adrenaline-pumping action sports, involving long hours of vigorous practice should undergo a complete cardiac work-up including an ECG, echocardiogram, exercise test, chest X-Ray and blood tests,” opines Mitra.

Being diagnosed with a heart condition is not the end of the road for any athlete, stress cardiac specialists, citing the example of Nigerian footballer Nwankwo Kanu, who successfully returned to the field after open-heart surgery to repair his “very weak” aortic valve.

Depending on the nature and severity of the problem, age of the patient, level of activity and other factors, the cardiologist may opt for medical management, interventional therapy, surgical treatment or simply diet and/or lifestyle modification to relive symptoms and improve or conserve heart function.

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