A UK soccer player nearly died of a heart attack while playing this weekend. He's still in a critical condition.
This horrible incident reminded me of the spate of sudden cardiac deaths which afflicted Swedish elites maybe 20 years ago. Was any cause for that ever found?
Oh, you mean "
TWAR"? I have my own opinion on that matter...
I thought the rash of cardiac deaths from elite cyclists was suspected to be side effects of their blood becoming too viscous to be pumped efficiently, due to abnormally high concentration of red blood cells. J-J, was that what you were thinking of? That didn't look at all like TWAR.
Defibrillators and CPR
work wonders.
Hypertrophic cardiomyopathy has been the cause of sudden death for a number of junior aged athletes. That could be another possible cause.
Oh, I think there was no question what caused the deaths of the cyclists. But the orienteers (I remember there being only one, Melker Karlsson) was said at the time to be suspected to be related to TWAR. For reasons that were difficult to understand.
There were certainly several other cardiac deaths among Swedish orienteers in the early 1990-ies that were - or at least were suspected to be - related to TWAR.
Several years of research have not produced one fully conclusive answer - the cause may or may not have been a single factor like TWAR or a combination of many linked factors (and I don´t think doping is one of them).
Here's the differential diagnosis of cardiac-related sudden death in young athletes in descending order of frequency:
Hypertrophic cardiomyopathy
Coronary artery anomalies
Atherosclerotic coronary artery disease
Myocarditis
Other etiologies (less common):
Right ventricular dysplasia
Marfan's syndrome
Conduction system abnormalities
Idiopathic concentric left ventricular hypertrophy
Substance abuse (e.g., cocaine, steroids)
Aortic stenosis
Mitral valve prolapse
In the case of the Swedish O deaths, mycoarditis was the predominant finding (Eur Heart J 1996; 17: 902-910) however evidence for Chlamydia pneumoniae (TWAR) was overall weak. No toxicology was obtained although doping was unlikely. Blood doping has been implicated in causing myocarditis- again unlikely in this cohort.
Substance abuse, particularly cocaine more likely in professional cyclists and footballers. For the record notable substance-related deaths include Marco Pantani (cocaine) and Tom Simpson (Mont Ventoux, amphetamine).
As far as T/D's comments about defibrillators and CPR working wonders, I think the figures I have seen indicate that defibrillators work wonders in about 1/2 of cases, and the success rate for CPR is about 1/7, though the current technique may be a little better than what was used a few years ago. So I would characterize these methods as well worth a try, but hardly to be counted upon as a guaranteed miracle. (The somewhat disappointing 1/7 success rate for conventional CPR was something I believe I saw mentioned in defibrillator advertising, not something that I recall being brought up in the CPR class I took quite a while back).
but if someone requires CPR, you'd have a hard time making their situation worse by having a crack at it
Going back to 1976, two elite UK orienteers Mike Wells-Cole and Dave Menzies died within months of each other. Mike was in the British Squad and had finished 18th in 1970 WOC and Dave was ranked in the top 20 in the UK. I believe both were considered the result of myocarditis, having recently had viral infections and dying soon after training/racing
Yes Eric, a lot of the statistics are like getting average patient temperature for the hospital. In the case of sudden cardiac deaths, averaging over the whole sample brings in people with previous heart attacks, for whom revival is less likely due to the extent of the damage. For athlete-related accidents, the most recent stories reinforce what I prefer to believe:
* Prompt help: good outcome;
* No help: bad outcome.
I would like event organizers to keep this in mind.
And Muamba is alive today as a result, thanks to the policy adopted by the Premier League to have an ambulance / EMT at games and defribrilators available- ie rapid intervention is key. The FA have also endorsed the other major angle here- prevention through regular screening with medical history and appropriate testing (minimum EKG), although zero risk seems to be their mantra which is simply not feasible in life or medicine.
Not sure how many of you North Americans here are aware of this but two more completely unexpected sudden deaths have taken place among the very top Swedish elite orienteers long after the publicity of the "oienteering death" in the 90's had faded.
Arto "The Champ" Rautiainen (Swedish national team runner in the late 90s) died suddenly during a training in 2004 at age 36 and Mikael Olofsson (occaisionally representing the Swedish national team) died suddenly shortly after training in 2008 at age 27. Both were representing the club IFK Göteborg at the time when they died and both left very young children behind.
I don't think the cause of any of these two deaths have been conclusively established.
This discussion thread is closed.