MARCH 19, 2012
Lisa Nainggolan 

London, UK - A 23-year-old British soccer player remains in critical condition in the hospital today after suffering a cardiac arrest during a game on Saturday evening. Fabrice Muamba, who plays midfield for the club Bolton Wanderers, collapsed in the 41st minute of the match at Tottenham in London and was quickly attended by doctors for both clubs, as well as a consultant cardiologist who happened to be in the crowd, Dr Andrew Deaner(London Chest Hospital), who reportedly insisted that the player be taken to his specialist unit.

Muamba received prolonged resuscitation on the ground and en route to the hospital, where his heart eventually started working. The quick treatment he received has been praised. He is still under sedation in intensive care at the London Chest Hospital.

The case has received unprecedented media attention and led to calls for universal national screening of soccer players and other athletes in the UK, as is done in Italy. However, as it's likely that Muamba—as an elite soccer player—would have been screened, one cardiologist told heartwire she believes he may have a very rare condition.

Dr Sarah Clarke (Papworth Hospital, Cambridge, UK), vice president of education and research at the British Cardiovascular Society, says: "[Muamba] would have been deemed fit and healthy from what we can gather; his heart is to all intents and purposes normal, so this has to be more of an electrical or electrolyte imbalance or an ion-channel abnormality, one of those rare genetic problems that can present in this way." It's important to note that "less than 1% of cardiac arrests that occur out in the community will be this healthy-heart/ion-channel electrical-abnormality group, of which we are surmising—from what we know—that he is likely to fall into," she says.

Dr Stephen Cox (Cardiac Risk in the Young [CRY], Tadworth, UK) told heartwire that, in the UK, 12 people under the age of 35 die every week, or 600 per year, from sudden cardiac death.

More widespread screening would help identify more affected individuals and save lives, he says. But he too believes Muamba would "have been screened because he was a [Football AssociationAcademy player, and they have a strong screening program, and it's not just ECG, he would have had ECG and echo as a routine. They are one of the few sports [in the UK] to have instigated it to that level."

But "there are certain conditions that will not be detected through screening," Cox added. CRY's consultant cardiologist, Dr Sanjay Sharma (St George's Hospital, London), who runs Britain's only cardiac unit for sportspeople and who is official cardiologist to the London 2012 Olympic Games, told the Independentnewspaper that 80% of conditions causing sudden death will be picked up by screening. "I am surprised the heart problem was not picked up. The medical screening these players get is extremely comprehensive".

Muamba was born in Kinshasa, Democratic Republic of the Congo, and came to the UK at the age of 11 after his father was granted political asylum here. Asked whether Muamba's background might hold any clues as to what happened on Saturday, Cox said that any heart damage, such as myocarditis from rheumatic heart disease, would have been seen on echo: "Something like that would have been identified on screening."

Cox added that one of the areas of research at his organization involves looking at ethnicity and how this affects the interpretation of ECG and other screening.

In 2005, the European Society of Cardiology recommended screening of young people taking part in competitive sport, a move that was then endorsed by the International Olympic Committee (IOC), says Cox.

Obtained from heartwire... 

10/4/2013 10:50:11 pm

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