Athletes a bigger heart risk

2007-09-02 22:26

Maria Cheng

Vienna, Austria - Athletes with an irregular heartbeat risk losing much more than just the competition.

Heart problems like an abnormal heartbeat, or arrhythmia, are more apparent and potentially fatal in athletes, doctors at the European Society for Cardiology meeting in Vienna said.

Three soccer players have died in recent weeks after collapsing on the field.

"Sport acts as a trigger," said Dr Domenico Corrado, of the University of Padua. In research presented at the meeting, Corrado said that screening athletes to find those who were at risk could save their lives.

The research was funded by the Italian government. Corrado said he had no ties to companies involved in checking athletes.

Athletes genetically predisposed to have an irregular heartbeat might not even be aware of their condition - until it was too late - doctors said.

Exercise produces adrenalin, which can worsen the condition and result in a sudden heart attack.

Last week, Antonio Puerta became the latest high-profile soccer player to die while competing.

The 22-year-old Sevilla midfielder lost consciousness and fell near his own goal during a Spanish league match. Doctors treated him on the field and he walked off, but then had a heart attack in the locker room and another in the emergency room of a Seville hospital.

Given electric shocks

He died three days later.

A day after Puerta's death, former Zambia striker Chaswe Nsofwa died minutes after collapsing on the field during a training session with Israeli club Hapoel Beersheba. The 27-year-old Nsofwa was given electric shocks and an external pacemaker but could not be revived by paramedics.

On Aug 24, 16-year-old Anton Reid of English League One team Walsall died after collapsing on the field.

Many fatal heart attacks are caused by an irregular heartbeat. Adrenalin produced during exercise may overstimulate the heart so that it essentially short-circuits.

When that happens, there may only be seconds or minutes to save an athlete's life. Because they have been exercising vigorously, many athletes who have collapsed will not have enough oxygen in their bodies to allow the heart to start pumping again, even if a defibrillator is used to try restarting their heart.

Corrado said that Italy is the only country that mandates heart screening of all its professional athletes. Since 1981, Italian authorities have run heart checks on all competing athletes. The incidence of sudden, fatal heart attacks has dropped by nearly 90%, from four cases per 100 000 to 0.4 cases per 100 000.

Fifa, world soccer's governing body, deemed the risk of irregular heartbeats to be so great that before last year's World Cup in Berlin, its medical committee demanded that all players pass a thorough medical checkup including heart scans. Following the recent deaths, Fifa said it was considering expanding health checks.

"Athletes may have a silent but important heart disease that's not ... manifest," said D. Douglas Zipes, a cardiologist at Indiana University School of Medicine. Though little data exist, Zipes said that due to a genetic disorder, some athletes have hearts that get abnormally big when they train.

'It's very imperfect'

"Athletes in general are spurred on to deliver their ultimate performance," Zipes said. "That may be very dangerous if they have a heart condition."

Corrado estimated that the cost of Italy's heart screening program is about $82 per athlete. Other countries are not convinced that screening would be cost effective, given how few athletes are at risk.

Concerns have been raised about the reliability of the screening test, which relies largely on echocardiograms, a test that shows if the heart is pumping normally.

"As a screening test, it's very imperfect," said Dr Gordon Tomaselli, chief of cardiology at Johns Hopkins University and spokesman for the American Heart Association. "It can pick up many of the things that cause sudden death, but not all of them."

Even if athletes with suspicious tests were identified, experts said that would not necessarily mean that they would one day collapse on the field.

Doctors said that more awareness about the potential dangers is key to preventing future deaths.

"Coaches should pay more attention to their players' symptoms," Zipes said. "If an athlete is complaining about chest pains or shortness of breath, those are warning signs that should not be ignored."

AP Sports Writer Chris Lehourites contributed to this report from London.

- SAPA