Rugby player Norman Berryman, 42, from New Zealand, died after suffering a heart attack and in 2012, 24-year old footballer Fabrice Muamba suffered a cardiac arrest during a match. Paramedics were able to resuscitate him, but his professional career was brought to an end.
Dr Chuang Hsuan-Hung, cardiologist from Mount Elizabeth Hospital, explains the special screenings available to athletes.
Are athletes required to undergo heart screenings?
Athletes are screened and reviewed regularly by experienced physicians for health issues that may affect them. If there are heart issues they would be referred to the Sports Cardiology Clinic in Changi General Hospital or at our centre at Mount Elizabeth Hospital.
Have you ever spotted a potential heart issue in an athlete?
I remember a young national hockey player who was experiencing palpitations during exercise. Our evaluation showed that she had an irregular heart rhythm. Her parents were concerned about her continuing to play. After counselling, we performed a successful radiofrequency ablation (a procedure where part of the electrical conduction system of the heart is removed by high heat) and she was able to return to competitive sports. Not every athlete with heart problems needs treatment or has to give up sport. However, their safety during competition is always our utmost concern.
Some sports are more strenuous on the heart. Do certain athletes receive more attention?
No athlete’s health is taken for granted. During screening, particular attention is paid to those who have symptoms such as palpitations, fainting spells, or other chest discomfort. Those with a family history of heart disease, sudden death or cardiac risk factors are also carefully screened.
Which heart screenings are especially useful for athletes?
Most sports-related sudden deaths in older athletes are related to atherosclerotic coronary artery disease. On the other hand, the predominant causes of sudden cardiac death in younger athletes is often related to genetic heart muscle disease or abnormalities. Basic tests such as the 12-lead electrocardiogram (ECG), 2D echocardiography and treadmill stress test are useful for initial screening. Depending on the outcome of these, further tests, such as a Holter recording, tilt table testing, magnetic resonance imaging (MRI) or CT scans might be necessary. It is important to understand that no test can totally rule out sudden cardiac death.
Are these athlete-specific heart screenings recommended for the general public?
For the general public and older competitive athletes (35–40 years of age or older), knowledge of a personal history of coronary artery disease, risk factors and/or familial occurrence of premature heart disease is useful in screening for underlying cardiac conditions. Medically supervised exercise stress testing is also advised for men above 40 years of age (and women aged above 55 years) who wish to take part in vigorous training and competitive sports and have more than two coronary risk factors (other than age and gender). It is never too early to find out if you might have an underlying heart problem.
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