Posted on 03/19/2012

Teammates and Opponents Request Heart Screens 

LONDON--Fabrice Muamba, 23, an English Premier League soccer midfielder with the Bolton Wanderers, collapsed in sudden cardiac arrest during the televised Football Association Cup quarter finals on Saturday. He was given CPR and treated with a defibrillator at the scene. Muamba remains in intensive care at the London Chest Hospital, but he is showing "small signs of improvement," the hospital said in a statement Monday. His heart is now beating without the help of medication, he is breathing on his own, and he is moving his arms and his legs. Later in the day, after emerging from a medically induced coma, Muamba recognized his family and was beginning to speak, asking about his son, Josh. The statement added that Muamba's long-term prognosis remains unclear and he will continue to be closely monitored. 

Fabrice Muamba with his son, JoshuaOn Sunday, the hospital and club stated Muamba was admitted to the hospital (Saturday) after collapsing in SCA and that he "received prolonged resuscitation at the ground and on route to the London Chest Hospital, where his heart eventually started working.”

His fiancée, Shauna, has appealed to the global soccer community for prayers. His shocked teammates and their opponents, the Tottenham Hotspurs, have requested heart screenings.

How Can This Happen to An Otherwise Healthy Athlete?

Muamba is not the first to fall so dramatically unwell during a match, according to The Guardian. Since the 19th century more than 80 soccer players in the UK are known to have died suddenly while playing, all young men, all otherwise apparently fit and healthy. According to cardiologist Tom Riddington, MD,  of Yorkshire, it is no secret why these sportsmen die or collapse: it is called hocum (hypertrophic obstructive cardiomyopathy (HOCM) or hypertrophic cardiomyopathy (HCM). Young, fit athletes have hearts that are a little different from most people. Their well-exercised heart muscle has been reshaped to adapt to the stress of regular, vigorous training.

This remodelling of the heart is useful, as it helps to pump blood more effectively around the body. But in HCM, a genetic abnormality causes the muscle wall of the heart to grow far thicker than it should. Repeated training makes the problem worse – the muscle wall can become so thick that it stops the normal flow of blood going in and out of the heart. This is where things get dangerous.

A heart that cannot pump blood properly causes problems that usually affect far older and far less healthy people. An athlete with HOCM might seem very fit but the heart is struggling like that of an unwell 80-year-old. Sudden strain, like a football match, demands an overwhelming effort. If he is lucky, shortness of breath or chest pain is a warning sign that something is wrong. But often the first signs of trouble are collapse or what doctors call sudden cardiac death.

The heart's ability to pump has been compromised so severely that it cannot beat in a coordinated way any more. If this happens in hospital, CPR and electric shocks from defibrillators might work to start the heart beating properly, but it is still a very serious situation. If it happens on a soccer field, the outlook is more difficult, but not impossible.

Sports doctors know the risks of HCM. Only a small proportion, 0.2%, of the population are thought to be at risk of its effects. But the consequences of a missed diagnosis are tragic.

Across Europe there have been studies into sudden death in athletes and in Italy there is already a screening program underway, where soccer players are given simple heart tests to help detect the disease. In most people, exercise is key to a long and healthy life.

In a very small minority it can kill. Pinpointing the people at risk is difficult but doctors are working to try to prevent this devastating condition from causing needless future deaths.

Muamba's diagnosis has not yet been reported, but HCM is suspected.

SOURCES: TheGuardian.co.uk, Telegraph.co.uk, Business Week, Atlanta Journal Constitution, Yahoo Sports, ESPN, CNN

 

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