20 March 2015 / 11:05 am
There is nothing as shocking as hearing about a sportsman die from cardiac arrest. These athletes are expected to be some of the fittest and healthiest people in the world. Headline events such as the collapse of Fabrice Muamba, the deaths of Italian footballer Piermario Morosini and marathon runner Claire Squire have focused attention for the need for pre-participation screening programmes and raised concerns that heart checks need to be performed more comprehensively and more frequently.
Cardiovascular disease remains the commonest cause of death in Jersey, yet nearly half of those who die had no warning that there was anything wrong with them before their death. The lifetime risk of developing angina or having a heart attack is 50% at the age of 50 and women are three times more likely to die from cardiovascular disease than from breast cancer. These statistics are not widely appreciated.
Sudden cardiac death in the young
There are many inherited structural and electrical abnormalities that lie dormant but that can present with cardiac arrest. Sudden death in the young is unfortunately more frequent than many expect. Every week in the United Kingdom at least twelve teenagers and children die suddenly from heart conditions that they knew nothing about. These heart conditions affect approximately 1 in 300 young adults and include heart muscle abnormalities such as the cardiomyopathies and electrical irregularities such as heart block and the long QT syndrome. Unfortunately these catastrophic deaths are usually provoked by exercise and therefore often manifest with collapse during sport. In Jersey we are unfortunate to have had several deaths in recent years in young, otherwise fit, adults from these conditions.
What can we do?
In many countries and in most high-level sports, heart screening is mandatory before competition. After the introduction of heart screening in Italian athletes, the incidence of sudden cardiac death in young adults fell considerably. These screening programmes are recommended by sporting bodies such as FIFA, the International Olympic Committee with advice from the American Heart Association and the European Society of Cardiology. At the moment, screening for these cardiac conditions is not funded by the state in the Britain and is largely provided by independent ventures such as Heart for Life in Jersey (www.heartforlife.co.uk) or via charities such as Cardiac Risk in the Young in the UK (www.c-r-y.org.uk).
What is a heart-screening test?
A typical heart-screening test would consist of a review of your medical history, a physical examination, a recording of your heart rhythm (electrocardiogram or ECG) and a heart ultrasound scan (echocardiogram). These tests can pick up most of the heart conditions that can cause sudden cardiac death. Unfortunately not all conditions can be detected and subtle, rare cardiac abnormalities can still exist with normal screening tests.
Up to 90% of premature vascular disease is preventable. Obesity is on the increase and doubles the risk of having a heart attack. Cigarette smoking is a common contributor to heart attacks and premature death in the young. Even one cigarette a day is enough to increase the risk of suffering a heart attack.
Should we be doing more?
There are many other things we can do to reduce the risks of sudden cardiac death. Everyone competing in sport, from the weekend amateur to top end professionals should consider having a heart-screening test. If you are over forty then you should have an estimate of your heart disease risk with your GP or cardiologist. Early detection of heart disease allows interventions with drugs and lifestyle changes to significantly reduce the risk of heart attack and strokes.
Start your campaign
The Oliver King Foundation (www.oliverkingfoundation.co.uk) has recently generated over 100,000 signatures in a petition to the UK government asking to legislate for mandatory heart screening. Automatic external defibrillators (AEDs) should be instantly available at every public location and sports field in the Island, not just for the players but also for the supporters. In Jersey we must ensure that every school has at least one AED. Jersey’s heart charity the Jersey Heart Support Group (www.jerseyheartsupportgroup.org) has already started funding AED placements in Jersey. Donations to the charity will help protect our society. Finally, everyone should learn basic life support with courses provided by organizations such as St John’s Ambulance. Thanks to your support and new skills, one day you may save someone’s life.