Heart problems among footballers - what you need to know

Ranjan Shetty Cardiologist
Manipal Hospitals
Get tested early and then regularly to rule out possibilities of issues with the heart...

From football legend Diego Maradona to Fabrice Muamba and many other professional athletes, heart problems have ended careers and in some cases, tragically their lives. 

Indian football received its biggest shock in recent years when U-17 World Cupper Anwar Ali, a young defender who is only 19 years old, was diagnosed with Apical Hypercardio myopathy. 

He joined Mumbai City for a then-record fee of INR 30 lakh for an 18-year-old but since getting diagnosed with a heart problem, the youngster has not been able to make any progress in his career. 

He was advised not to play by medical experts in Mumbai and France. AIFF had consulted AFC's (Asian Football Confederation) Medical Committee Chairman, Dr Dato Gurucharan Singh, and the medical practitioner stated that it would be best for Anwar Ali to refrain from participating in competitive sports.

Professor Sanjay Sharma, chairman of the Cardiology Consensus Panel for England's FA, however, suggested that since the risk is not very high, Anwar and his family should be made aware of the same and the final decision to play should be left to them. 

Heart problem among footballers has been a topic up for discussion for two decades. The major football governing bodies across the globe has made medical tests mandatory and medical experts also have opined that tests should be done regularly as heart issues can happen to anybody regardless of their physical fitness level. 

Anwar Ali India U23

Goal spoke to Dr Prof Ranjan Shetty, the HOD & Consultant in Interventional Cardiology at Manipal Hospitals, Bengaluru, to find out more about heart problems that athletes deal with.

"There are two kinds of diseases we need to focus on. Hypercardio myopathy (HCM) - this is found in one in 500 people. It is a common anomaly, it is a genetic issue where heart muscles become thicker, for most people it isn't a big issue. Especially for young athletes, it is common," Shetty revealed.

He further added, "Beyond 35, the common condition would be heart attacks because of blockages. Athletes are meticulous and exercise regularly but they could also have blocks because of cholesterol and family history.

"Even people with smaller blocks, 30-40 per cent block also, the covering of the block ruptures. The reason for that could be extreme excitement. The actual attack. is like an earthquake, it could happen to anyone."

Proper tests are the only way to find out an issue like HCM. It needs to be ruled out regularly at various stages of a footballer's life to avoid complications. 

"Most footballers going into competitive football should get Electrocardiogram (ECG) and Echo (Echocardiogram) done. Especially if family members have had cardiac arrests, they must do ECG and Echo so that HCM can be ruled out.

"To prevent other heart diseases, they should be careful with their lifestyle. They (footballers) exercise very well, but too much exercise without proper training can also cause issues. Sometimes people forget these things. Extreme exercise of any nature can hurt heart muscles so don't overdo it. Warm-ups and cool-downs are also extremely important."

The situation regarding heart problems among athletes is not too different in India compared to the rest of the world. It is still as common but there is a lack of awareness among sportspersons. 

"In India also, it is one in 500 but not everyone is at high risk. It is still common in young athletes in India. It is not about stopping them from playing. That person could be at low risk. High-risk ones are bad, but most of them are low risk.

"If the MRI shows zero scars, then there is nothing to worry about. if it shows more than 10 per cent scar, then he will need more care. Risk certifying is extremely important when dealing with HCM. 

Every athlete needs to be tested when they are starting out their professional career. Even if the results are negative, they should get tested every five years because there is no particular age at which complications can arrive. 

"When you have so many athletes, you will find many with HCM. If they find nothing, they can repeat the tests every five years. Otherwise, yearly tests could be needed."

"In HCM, the genes may not manifest young, they could manifest later. If it does later, this disease will be milder. The more dangerous ones come up at a younger age. 

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"There is one more disease ARVD (Arrhythmogenic right ventricular dysplasia), that is the second most common (In the world), and the most common in Italy. Everywhere else, HCM is the most common.

"What Sourav (Ganguly) has is atherosclerosis, which is more common in India. That is more due to the lifestyle in India and the diets. Excess carbs, less protein and all that," Shetty explained. 

If you or your friends are athletes, ensure that you have completed an ECG and Echo at least at the age of 18 and a cholesterol checkup at 21. And most importantly, don't panic. 

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