FIFA, the international governing body for football, have just backed a plan to make sure a defibrillator is easily accessible at all major football stadiums. This emergency equipment is used to shock the heart back into action after someone has suffered a cardiac arrest.
Dr Amanda Varnava, Consultant Cardiologist at The Physicians’ Clinic was interviewed on Radio 5 Live after the announcement and she explains which this is a good move. “Everyone will remember the reports from March last year when Fabrice Muamba suffered a cardiac arrest on the pitch of a televised game between his team Bolton Wanderers and Spurs – paramedics and doctors battled to save his life by giving cardiopulmonary resuscitation and using a defibrillator to shock his heart back into rhythm. Without this prompt attention he would have died,” explains Dr Varnava.
Just days later, D Venkatesh aged 27, a footballer in India was not so lucky when he collapsed during a local league game in Bangalore. Not only was there no defibrillator, there was no ambulance and he was dead on arrival in hospital.
Footballers and cardiac arrest
Death from cardiac arrest in young people is rare but footballers are at a higher risk because of:
- The strenuous but unpredictable physical exercise involved: short bursts of intensive activity followed by periods of waiting.
- Dehydration: after playing a long match, players can become very physically stressed.
- Mental stress: competing at national level, with the pressure from other players, management and the crowd, stimulates the body to release lots of adrenaline and other stress hormones.
This doesn’t mean that exercise is bad – doing regular exercise prevents heart disease, heart attacks and strokes but it does mean that facilities should be available in case a young person collapses during a game.
What causes cardiac arrest?
When the heart goes into cardiac arrest, it stops beating because its electrical rhythms go haywire. There is usually no sign that anything is wrong and the underlying problem is usually an inherited disorder. Around one in 300 of the population may have this type of problem but are never aware of it. “FIFA have reviewed the rising trend for deaths from cardiac arrest in young footballers and have concluded that having easy access to a defibrillator is the best way of saving lives. If a footballer collapses suddenly with no other players near him, it’s important to act immediately. CPR to keep blood moving through the tissues needs to be started within a couple of minutes and the defibrillator can be used even by an untrained member of the public and will deliver shocks if necessary,” says Dr Varnava.
Using a defibrillator
The type of defibrillator that is available at football matches delivers instructions to the person who has to use it, telling them what to do in simple language. “Placing the defibrillator connections on the bare chest of the patient allows the equipment to detect the heart rhythm and it will then give instructions on how to deliver a shock. This should reset the electrical system in the heart so that it starts beating normally again.”
After a cardiac arrest
Although most people are unaware of any problems before a major incident, it is possible to detect abnormal heart rhythms and to prevent further problems by fitting a pacemaker. Fabrice Muamba made a full recovery but has since had to retire from football and has since been fitted with an implantable defibrillator.
Is screening possible?
Up to half the people who have a cardiac arrest during strenuous exercise have some form of warning beforehand. They might collapse during exercise, have rapid palpitations or chest pains. “Any if these symptoms need very prompt investigation but other young people who are fit and well and have no symptoms can be given pre-participation sports cardiac screening to identify heart conditions before they cause problems. For many sports, professional football included, these cardiac screens are mandatory,” explains Dr Varnava. Dr Varnava provides cardiac screening for many premiership football teams and is on the FA advisory panel. At The Physicians' Clinic she is able to offer a cardiac screen to anyone involved in sports or indeed anyone taking up a new form of exercise or embarking on a new fitness programme. Screening involves a consultation, an electrocardiogram (ECG) an echocardiogram (an ultrasound heart scan). If you are over 35, you may also need an exercise ECG test. Find out more about Dr Amanda Varnava or book an appointment.