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What Can Fabrice Muamba's Cardiac Arrest Teach Us?

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Midfielder Fabrice Muamba collapsed and went into cardiac arrest on the soccer pitch this weekend in front of tens of thousands of horrified onlookers during a British Premier League match between Muamba's Bolton Wanderers and Tottenham Hotspur.

Athletes leave the field because of injury all the time, but they don't normally do so while wearing oxygen masks and with medics frantically trying to get their hearts beating again. Normally when an athlete goes down, it is not serious enough to cause an end to the game, or tears from players and fans alike. But this was a moment that transcended sports and reminded us of the realities that some of us like to use sports to escape from. Muamba's heart didn't beat again for 78 minutes, but thankfully he has since shown steady signs of improvement.

Looking at this case, I'm left wondering if we are truly doing all we can to ensure our sports are as safe as they can be, not just for Olympic athletes or professionals but for younger and amateur athletes as well.

Tragic accidents are hard to eliminate completely from sport. Lessons can be learned and measures can be taken to reduce the rate of future accidents, but ultimately any physical athletic activity runs the risk of injury, and occasionally serious injury as well. But the majority of athlete deaths seem to be very preventable. The leading cause of death amongst athletes is sudden cardiac arrest, usually as a result of a heart abnormality that was prone to cardiac arrest.

Last year a high school in Michigan was rocked when 16-year-old Wes Leanord collapsed and later died after hitting the game-winning shot in a high school basketball game. The cause of his death was ruled as cardiac arrest due to an enlarged heart. To Wes' friends, classmates and family who endured the horror of witnessing his death during what should have been an amazing moment in his young life it must have seemed such a shock that something like this could happen. He was so young and healthy, how could his heart just give out like that?

Unfortunately, Wes Leanord's story is not rare, nor was it rare when Jenny Snyder died on the soccer field at the age of 17, and it wasn't rare when high school senior Reggie Garrett's heart stopped after throwing a touchdown pass. In fact sudden cardiac death occurs 60 to 80 times annually in young athletes in the United States alone, and will happen to one in every 44,000 NCAA athletes.

Studies have identified the leading cause of sudden cardiac death amongst young athletes is a heart enlarging condition called hypertrophic cardiomyopathy (HCM). This condition can be identified through a basic electrocardiogram (ECG) test, in addition to other tests and symptoms. While the ECG test itself can't confirm the diagnosis, it would raise red flags that would alert medical professionals that more tests (such as an echo cardiogram) are warranted. Should a confirmation of HCM be found, the athlete would no longer be able to take part in sports that require heavy cardiovascular activity (depending on the severity of their condition), but in many cases with treatment and monitoring they would still lead full and complete lives.

It was these basic cardiac screening tests that Major League Soccer's Toronto FC ordered for their 2010 second round draft pick, 17-year-old Zachary Herold and eventually led to his diagnosis of having an enlarged heart due to HCM. Zachary's condition forced him to retire from soccer. The young soccer player must have felt devastated that his playing career was cut short just before he was to turn professional, but the results could have been far worse. Zachary had been playing high school and amateur soccer, a sport heavy in cardiovascular activity, for years with a heart that was prone to sudden cardiac arrest. He could have easily ended up just like Wes Leanord, Jenny Snyder, or one of the many other young athletes each year who die as a result of this condition.

Questions still remain about what level of screening professional footballer Fabrice Muamba's heart went through before he was allowed on the pitch for Bolton, but the risks of sudden cardiac death are just as great on the amateur or student athletic level as well, where heart screenings are rare. Sick Kids Hospital, The Canadian Sads Foundation and American organizations such as Young Champions and the Championship Hearts Foundation have been lobbying for years for mandatory screenings (including ECG tests) for young athletes and organizing free heart screenings when possible.

Making this screening process mandatory for young athletes would prevent hundreds to thousands of deaths over the years. The cost of the screenings would be a minimal financial burden to either the athletic organization or to our public health care system, but the loss of even one more life, when we know how to prevent it, is immeasurable.

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