Anwar Ali appeared before the AIFF Medical Committee on Sunday along with his doctor who joined in the video conference from London. After being stopped from playing by the All India Football Federation last month, Anwar Ali sought the advice of FA Cardiology Consensus Panel Chairman Prof. Sanjay Sharma, who is a leading authority on the topic of HCM, sudden cardiac death in athletes and has collect immense amount of data and done thorough research over the past few decades.
During the meeting, Prof. Sanjay Sharma discussed in detail the case of Anwar Ali and answered the queries from the AIFF Medical Panel regarding the complexity and degree of the condition in Anwar Ali. Prof. Sharma said that Anwar would have been cleared to play in England given his condition is totally asymptomatic and has no obvious disqualification factors like family history.
He also said that many players with similar and even worse degree of HCM are currently playing in the top competitive leagues in Europe and UK. He also pointed out that the guidelines regarding competitive sports participation with HCM have been reviewed and revised this year itself and are much more liberal than before on cases like Anwar.
As one of the leading Sports Cardiologist in the UK, Professor Sharma is the Cardiologist for the English Institute of Sport , British Rugby League and the British Lawn Tennis Association. In the London 2012 Olympics he led the medical team for the triathlon, marathon, long distance cycling, open water swim and the 20K walk. He was also the lead cardiologist for the polyclinics during the Olympics and Paralympics.
Professor Sharma’s has an international reputation in cardiovascular adaptation in athletes, sudden cardiac death in the young and heart muscle diseases and has published over 240 scientific articles including original papers in highly rated peer reviewed journals. Professor Sharma was awarded the status of Fellow of the European Society of Cardiology and elected as a nucleus member of the Sport Cardiology section of the European Association of Cardiovascular Disease Prevention and Rehabilitation in the 2008.
In February 2015 Professor Sharma was awarded 1st Viviane Conraads Outstanding Achievement Award for Established Researchers by the European Society of Cardiology and in 2017 he was awarded a Doctorate from Aristotle University for his contribution to Sports Cardiology. Prof. Sanjay Sharma is also the Chairman, The FA Cardiology Consensus Panel.
In his report, Prof. Sanjay Sharma stated: “Anwar does not have any obvious risk factors such as a family history of sudden death from hypertrophic cardiomyopathy, syncope, severe left ventricular hypertrophy or exercise induced arrhythmias or non-sustained ventricular tachycardia on the Holter monitor. His 5-year risk of sudden cardiac death according to the ESC risk calculator is 2.2 per cent (i.e annual mortality risk of just under 0.44 per cent). It is important to emphasise that the presence of left ventricular scar is not incorporated in the ESC 5-year risk calculator, however, the indices that are incorporated (age, syncope, left atrial diameter, left ventricular wall thickness, left ventricular outflow gradient and non-sustained ventricular tachycardia) perform well in identifying high risk individuals.
“The additional risk of the stresses of exercise on potentially fatal arrhythmias is unknown, however based on a study in deceased Italian athletes compared to the relatively sedentary population, this additive risk is 2.5 times the risk of a relatively sedentary person. Based on these figures Anwar’s annual risk is approximately 1 per cent per annum, therefore it may be considered reasonable for him to participate in competitive football."
Given that Anwar has got the green light from the authority and top expert in the world on the condition of HCM, AIFF will reconsider the matter and take a decision on his case.