Young people exercising more than 10 hours a week should be screened for hidden heart problems and all sports coaches should have CPR training, doctors have said following Danish footballer Christian Eriksen’s cardiac scare. The Inter Milan midfielder stunned a global audience of millions as he collapsed on the field near the left touchline at the end of the first half of Denmark’s opening Euro 2020 clash with Finland on Saturday. Medics who performed cardio pulmonary resuscitation on the player were praised for averting tragedy. While Eriksen recovers in hospital, a former Bayern Munich club doctor now working in Dubai said even fit young people can have undiagnosed but potentially life-threatening heart conditions. Dr Erik Hohmann, an orthopaedic sports physician at Burjeel Hospital in Dubai, worked with the German football club to screen junior players for undiagnosed health problems. "Arrhythmia or myocarditis due to a previous infection are the most common reasons for these kinds of incidents in young sportspeople during exercise," he told <em>The National</em>. “Thankfully, they are very rare. “I can only recall 10 or so incidents in the past 20 years and I did not find a single case in the young players I worked with in Germany. “Every young athlete that aspires to train more than 10 to 20 hours a week should have an annual examination. But with millions of athletes, this is not always financially viable.” Athletes and recreational sportspeople in the UAE could be at extra risk of heart problems due to the heat. With excessive sweat and fluid loss stripping the body of potassium - a vital component in regulating healthy heart function - doctors said re-hydration was critical to avoid risk. Former Manchester City player Marc-Vivien Foe suffered hypertrophic cardiomyopathy and died on the pitch while playing an international match for Cameroon against Colombia in 2003. And it was only life-saving CPR and several defibrillator shocks from medical staff that saved the life of Fabrice Muamba in 2012 after the Bolton Wanderers player went into cardiac arrest mid-game. According to the Mayo Clinic, just 1 in every 50,000 sudden cardiac deaths a year occurs in young athletes. But symptoms such as regular fainting, or a family history of doing so, should encourage a screening check. Dr Debabrata Dash, a consultant of interventional cardiology at Aster Hospital, Mankhool, said sudden collapse in athletes due to heart problems are unusual. “I am aware of few joggers or marathon runners sustaining cardiac arrest due to heart attack,” he said. “One probability is that he has a congenital condition which has not been picked up. “As Eriksen didn’t complain of any chest pain before the collapse, a heart attack is very unlikely to be the cause in his case. “Quick CPR is crucial in this situation. Everyone should be encouraged to learn how to do it to save lives.” Cardiomyopathy is another issue seen in elite athletes and regular sportspeople that can lead to impaired heart function. Intense exercise over a long period of time can cause the heart wall to thicken, making it harder to pump blood to the periphery. Irregular heart beats can also cause problems if left undiagnosed. “These are usually picked up in clinical exams as there would be signs of irregularity in the kind of echocardiography that we do in these athletes,” said Dr Hohmann, who has also served as a team physician for professional rugby teams in Australia. “But we do not pick up everything as examinations are not long term tests over 24 hours that would usually be required to spot this kind of thing. “When recreational athletes or part-time sportspeople take part in endurance events we would expect to see a thickening of the heart wall, that is normal. “At Bayern, we would look for any signs of a thickening of the heart or any problematic valve issues in younger players in particular.” Dr Hohmann said CPR training for coaches should be made compulsory and access to pitch-side defibrillators improved to reduce the chance of sudden death. Portable automated external defibrillator (AED) devices automatically diagnose life-threatening cardiac arrhythmias of ventricular fibrillation (VF) and pulseless ventricular tachycardia. It can treat them through defibrillation, the application of electricity which stops arrhythmia, allowing correct heart function to return. They are simple to use and only work when an abnormality is detected. Once deployed, a recorded voice instructs the user how to operate the device and where to place chest pads onto the patient. “The first minutes after cardiac arrest are super critical,” said Dr Hohmann. “The longer you wait for treatment the greater the chance for long-lasting brain damage. “Anyone involved in sports coaching should go on a basic cardiac life support course renewable every year to prevent lasting damage. “They should have the basic knowledge to do CPR and defibrillators are critical to improving the chance of life near sports venues. “They are simple to use and you can learn how to use one competently after only a minute or so.”
