The start of the delayed UEFA EURO 2020 brought excitement in this COVID-19 era, but the collapse of Denmark’s midfielder, Christian Eriksen–aged just 29–brought back dark memories for football1. Several footballers have died from heart conditions, but Cameroonian Marc-Vivien Foé is the only player to have passed away during an international football match, playing against Colombia in 2003. He collapsed mid-way through the second half of the game and despite all efforts from the medical team, he died shortly afterwards.
Despite screening, sudden deaths caused by heart (cardiac) problems are the leading cause of death in footballers. The most common factors underlying cardiac arrest include2:
A seminal study was conducted to investigate the incidence and causes of sudden cardiac death among adolescent soccer players in UK3. The study screened 11,168 Football Association players aged over a period of 20 years (1996–2016), where each player had an electrical recording of the heart (ECG) and an ultrasound scan of the heart (echocardiogram). During screening, 42 athletes (0.38%) were found to have cardiac disorders that are associated with sudden cardiac death, having presented with no symptoms prior to the screening tests. Of these 42 players, 30 had surgery or other treatment to rectify the heart defect and recommenced playing football; however, the other 12 stopped playing football altogether. Congenital or abnormalities with valves (which prevent backflow of blood) were evident in a further 225 athletes (2%). After the screening process was completed, there were 23 deaths from any cause, of which 8 of sudden deaths were related to cardiac disease. The average time between screening and sudden cardiac death was approximately 7 years.
According to the British Heart Foundation, “Hypertrophic Cardiomyopathy (HCM) is the most common inherited heart condition. Whilst cardiac screening amongst athletes may help detect the condition, we also stress the importance of everyone having a full awareness of their family medical history, especially if a member of the family has died suddenly under the age of 504.” This statement enhances the importance of regular screening programmes for young athletes. In addition to cardiovascular screening, increased awareness and education of cardiac arrests is of paramount importance, and providing resuscitation training and accessibility to defibrillators to save not only the lives of footballers but also their careers.
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Dr Azhaar Ashraf
