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 Medical
Sudden adult death syndrome

The death of a talented Cameroonian footballer has focused attention on the importance of regular checkups for even the fittest of sports stars, as well as the sinister genetic defect which may have claimed his life.

 
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The crowd was puzzled when Marc-Vivien Foe crashed to the ground. A team-mate trotted over to offer the 28-year-old forward a hand up but found he was unconscious. He was carried off on to a stretcher.

Never regained consciousness
It was only after the final whistle that they and their supporters heard that Foe had died without regaining consciousness. The fact that a superbly fit player should die of a heart attack is just one of the ironies of Foe’s untimely and abbreviated career. He was a hard-tackling, no-nonsense player who was handed two red and 14 yellow cards in his short tenure at West Ham.

Off the field the father of three lived quietly, concentrated on his fitness regimen, spurning the nightclubs and booze that many other soccer players build a lifestyle around. So if a clean-living, disciplined star can be struck down without warning on the field, what are the prospects for the brash, flashy, problem-child young guns in the Jabu Pule mould, who party away their nights and their careers?

No drugs involved
Initial speculation that Foe had been taking drugs was debunked after a post mortem as well as urine and blood tests. It seems Foe’s heart attack was triggered by an inherited heart disorder that often goes undetected until it strikes.

Foe was found to have died of hypertrophic cardiomyopathy (HCM). It’s a rare inherited condition, which causes the left ventricle of the heart to thicken. This interferes with its ability to beat properly because the thickened cardiac muscle hampers the transmission of electric impulses that make the heart pump properly.

Sudden Adult Death Syndrome
There are several similar disorders which some scientists now group under the acronym Sudden Adult Death Syndrome (Sads). Described as the adult version of cot death, the Sads heart disorders’ only symptom may be arrythmia - where the heartbeat races without warning.

The sudden accelerated heartbeat can cause fainting and - in rare cases - death, even in young, fit adults. Included in the disorders are so-called long-QT syndrome. Long-QT syndrome earns its name from the way the heartbeat bounces on a heart monitor. The cycle of the heart beating traces through four stages, what medical personnel call Q, R, S and T.

It’s when the Q and T stages look elongated on screen that health workers suspect long QT syndrome. It’s a clue to a fault with the electrical circuitry that controls the beating of the heart. The QT interval is when the electrical system recharges. When it takes too long to do so - hence long QT - the heart stops pumping blood out, depriving the brain of blood and leading to a sudden loss of consciousness and even death.

These conditions can trigger heart attacks during vigorous exercise, but also when the victim is asleep. Sometimes it strikes as they’re waking up. In the case of Long QT syndrome, about a third of sufferers may never develop any symptoms at all, while the other two-thirds may have experienced nothing more serious than a few fainting spells as children.

The symptoms may be so subtle that they would not have been revealed by the sort of medical examination that Foe would have undergone. It’s unlikely that the one that superstar showpony David Beckham underwent at Real Madrid underwent this month would have revealed any symptoms either.

All is not lost
But there’s hope. Scientists - and South African ones at that - are discovering more about inherited heart conditions daily. Medication can also help. In the case of Long QT syndrome, a type of drug called a beta-blocker can slow the heartbeat down.

What about athletes? Foe’s death is likely to bring renewed calls for athletes to be screened for heart conditions before taking part in sporting events. One such call was made in the UK last year after a runner collapsed and died within moments of completing the Bath half-marathon.

Anna Loyley was 26 years old and in good shape. It seems she had Long QT syndrome and was never aware of it.

Increased testing may soon be the order of things. Without it, the world of soccer would have been without Kanu, the talented Arsenal player who had a life-threatening heart-valve problem.

The problem was detected and operated on. Perhaps Marc-Vivien Foe’s untimely death will help raise awareness of the need for tests among athletes. - (William Smook)


 
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