Yashpal Sharma - one of India’s heroes of the historic win at the 1983 World Cup, died of a sudden cardiac arrest on the 13th of July. Cameroonian footballer Marc-Vivien Foe died of cardiac arrest on the pitch back in 2003 and Christian Eriksen had collapsed on the field during Denmark’s EURO encounter against Finland recently. There have been many instances of elite sports persons suffering a major heart attack on or off the field in history and this has triggered a debate amongst leading experts who have divergent views on the subject.
Dr G Ramesh, Consultant Interventional Cardiologist at Yashoda Hospitals outlined two major reasons for sudden cardiac deaths in athletes.
“Young adults with an arrhythmic substrate or predisposition to having abnormal heart rhythms due to genetic make-up, as happened recently with an international footballer," said Dr Ramesh.
He however gave a different explanation for the cause of the cardiac arrest which caused the death of Yashpal Sharma. Other Indian cricketers Sourav Ganguly and Kapil Dev also suffered a heart attack recently but recovered.
“The other cases are recent examples of our cricketers who have suffered a heart attack that was either treated in time, as with Sourav Ganguly or Kapil Dev, or proved fatal, as with Yashpal Sharma. The cause in these cases is a sudden plaque rupture in the coronary arteries, resulting in artery blockage and, in some cases, sudden cardiac death,” stated Dr Ramesh.
He added that the reason could be cholesterol deposition in the arteries which can be caused due to several factors such as a family history, diabetes, hypertension, obesity, smoking or excessive alcohol consumption, physical or mental stress and eating or dietary habits and poor lifestyle.
Experts have stated that the treatment for young athletes like Eriksen will be the insertion of an implantable cardiac defibrillator as well as the avoidance of predisposing factors such as extreme exertion.
Defibrillators are devices that send an electric pulse or shock to the heart to restore a normal heartbeat. They are used to prevent or treat arrhythmias, a condition in which the heart beats abnormally fast or slowly. Defibrillators can also restore the heart’s beating if the heart suddenly stops.
Doctors and medical experts say that having quick access to CPR and a defibrillator can increase a person’s chances of survival by nearly 90 per cent.
“A balanced lifestyle with regular health check-ups, including an ECG echo and stress test, would be the best way to prevent cholesterol deposition,” Dr Ramesh added.
Athletes are advised not to train in excess and take adequate rest. They should also get themselves checked regularly for cardiac tests to detect issues that are asymptomatic.
Cardiomyopathy, an inherited disease that affects the size, shape, or thickness of the heart muscle, and acute myocarditis, or heart muscle inflammation, are two other causes of cardiac arrest.
There is also a distinction between a heart attack and cardiac arrest according to experts.
Cardiac arrest is a malfunction of the heart’s electrical system. The average heart rate is 60-100 beats per minute. If the heart begins to beat at a rapid rate of 250,300 or 400 beats per minute, the heart will be unable to cope, and blood pressure will fall.
A heart attack is defined when the heart stops suddenly which implies that the heart rate has slowed down to such an extent that it is unable to generate inner blood for the rest of the body.
“So, a patient can have cardiac arrest followed by a heart attack [or vice versa]," says Dr Ravi Gupta, Wockhardt Hospital’s Cardiologist.
“Cardiac arrest can occur in conjunction with a heart attack. If we are fortunate enough to diagnose ventricular tachycardia and ventricular fibrillation ahead of time, it means that the patient has survived due to ventricular tachycardia or ventricular fibrillation, which requires implantable cardioverter defibrillators (ICD), implementation of this machine will give an internal shock to the patient and the patient will survive a cardiac arrest,” elaborated Dr Ravi Gupta.