Why Sportsmen die suddenly in the field

**Cameroon's Marc-Vivien Foe collapsed on the pitch during the 2003 Confederations Cup in France**

June 26, 2003 and Stade de Gerland, Lyon, France, was full to capacity. The din of thousands of fans cheering either Cameroon or Colombia during the Confederations Cup semi-final reverberated across the arena.

But 73 minutes into the match, the stadium fell silent. A Cameroonian player, Marc-Vivien Foe collapsed in a heap as millions watched the match on TV screens across the globe. He never woke up.

The final autopsy on the 28-year-old footballer’s death revealed that he died of condition called hypertrophic cardiomyopathy, a heart condition whose first symptom could be death.

Watching the drama unfold was Sanjay Sharma, Professor of Cardiology at St. George’s, University of London and one of Europe’s top sport’s consultants.

With 18 years’ experience and having reviewed top athletes in the United Kingdom including players from the country’s premier league, he could hardly understand why it took the medical team close to ten minutes to initiate some serious resuscitation procedures on the Cameroonian player.

In an interview with the Standard this week in Nairobi, Sharma says what happened to the footballer ought to be a wakeup call to all athletes, even those who feel they are in perfect health.

“You saw the player going down without any contact. The people just surrounded him not knowing what to do. But you could see his teammates were very concerned and worried but could do nothing. The referee came but he was of little help but could you blame him? The manager on the sidelines was seen arranging for a substitute as time ticked away. If resuscitation for such a serious case is not done in the first three minutes or so, expect the worst outcome,” he says.

He says such early intervention, even inside the field of play can give a player over 70 per cent chance of recovery. According to the doctor, the case of Foe deteriorated fast since there had been no previous case of a footballer collapsing in the middle of a match without any contact with another player.

“Sudden cardiac death is often the first clinical manifestation of underlying heart disease in young athletes. Most cardiovascular disorders responsible for SCD in the athlete are clinically silent and unlikely to be discovered on the basis of spontaneous symptoms,” he says.

The Tottenham Hotspur fan acknowledges that African players such as those from Cameroon have strong bodies that may seem to withstand enormous amount of stress on the field. That is why, he adds, many people were surprised when the player, who was among the Cameroonian giants fell all of a sudden and never regained consciousness.

“We all take it that athletes are the most physically fit individuals in the world, and it is true. They train hard, they cut disease risk factors such as overdrinking and smoking. They eat well and sleep well. In fact, research shows that they live longer than other individuals by seven years,” he says.

While such lifestyles lead players to an active career, the doctor says sportspeople are not protected from genetic factors that can predispose them to such sudden and fatal episodes.

“Inherent genetic issues and congenital conditions can affect the heart muscle and cut off blood supply to vital organs. Still, early diagnosis can prevent such hereditary conditions from becoming a life and death matter,” he says.

In other cases, the doctor says stringent exercising regime can also trigger heart rhythm disturbance and cause a cardiac arrest.

According to the doctor, the risk of a young athlete dying from a heart anomaly is almost three times greater than in young individuals leading a sedentary lifestyle indicating that the stresses of exercise could be triggers for a fatal cardiac condition.

Prevalence of sudden cardiac death is approximately 1 in 50,000 in young competitive athletes with black sportspeople more prone to such heart ailments than other races with 90 per cent of victims being male. For example, a black footballer has one chance in 3,500 of developing the condition while a black basketball player in the US has one chance in 5,000.

Of all sports disciplines, there are higher sudden death rates in football compared with other

sports activities, a matter that can be attributed to its popularity and high rate of participation across the world.

“The sudden death of an athlete is a rare event. However, such events are highly publicised and have a substantial emotional impact on the community at large when one considers that athletes are perceived as the healthiest segment of society. Such a death is highly emotional and devastating for families, peers, clubs and the sporting community,” he says.

Prof. Sharma says that since athletes especially in a country like Kenya are viewed as good role models by the youth, the way they take care of their health has positive outcomes among the population. He has a lot of respect for Kenyan sportsmen and women for their balanced approach to life and discipline.

“I have interacted with Kenyan athletes especially during the London Marathon where I was a lead cardiologist. They are very reserved and moderate in habits.

While in Kenya, Prof. Sharma will give several presentations on sports health both in Nairobi and Eldoret. He will also participate in a Philips Back to Rhythm challenge run in Eldoret.

About Professor Sharma

He has been a consultant since 2001

Chairman of the expert cardiac committee for the English Football Association.

Cardiologist for Tottenham Hotspur, Manchester City, Chelsea, West Ham, Crystal Palace, Fulham among others.

Cardiology advisor for English Institute of Sports