Ruth Walker: ‘Heart testing can identify danger signs’

By RUTH WALKER
Published on 09/09/2012 12:20

A 28-YEAR-OLD man dies while competing in the Great Scottish Run. A 30-year-old hairdresser dies during the London marathon. A premiership footballer suffers a mid-match heart attack. All make national headlines.

And while Fabrice Muamba made a miraculous recovery after his heart stopped for a full 78 minutes during an FA Cup match between Bolton and Tottenham in March, it none the less brought the issue of undiagnosed heart conditions and sudden death syndrome into sharp focus.

Claire Squires had already been diagnosed with an irregular heartbeat when she took part in the London marathon in April, but refused to let it stop her running. It may have cost her her life, though her charity page has since raised more than £1 million for the Samaritans, as the nation has responded in shock and sympathy.

At the time of writing, it was not known what killed Aubrey Smith, who collapsed during the Great Scottish Run last weekend, but at the moment he is part of a worrying statistic. Worrying for any amateur or professional athlete because, every single week, 12 apparently fit and healthy young people (that’s anyone aged 35 or under) die suddenly in the UK because of undiagnosed heart conditions. Eighty per cent of them will have had absolutely no symptoms to warn them their heart might simply stop beating at any second.

The Italians have been screening their sportsmen and women for more than 25 years – cutting the number of sudden deaths by 90 per cent – and in Scotland, a government-funded programme, based at Hampden but which travels around the country, is due to report by the end of the year on its findings, which could dictate policy north of the Border. The UK government, however, doesn’t consider a screening programme cost-effective.

In the meantime, should we be worried? With the Scottish Kilomathon coming up in three weeks, the Great Edinburgh Run and the Survival of the Fittest events next month, the Cairngorm Charmer and the Stranraer 10K, is sudden death among young adults on the increase? “Not to our knowledge,” says Dr Steven Cox, director of screening and deputy chief executive of the support group Cardiac Risk in the Young (CRY). “We’re just getting better at identifying it. When CRY first started, in 1995, we thought there was only one sudden death per week. Then it went to four, then at least eight. Now we’re saying at least 12 a week. That’s not because there’s something in the air or the water or due to over-exercising.

“There is some call that it may be due to the very high levels of stress at the highest level of sport,” he adds, “that might be an additional factor. We do know that sport increases your risk of sudden death if you have an underlying condition; it can act as a trigger but it’s not a cause.”

Of every 300 people CRY screens, one is identified as having an undiagnosed heart condition. In fact, in the five years leading up to the Olympics, it screened hundreds of athletes – 13 had an anomaly of some kind. “Ten of those had conditions that just needed to be monitored – you would only intervene if the problem was getting worse,” says Cox. “That’s the case with the majority of people we identify through screening, with whom we can stop something bad happening later in life.”

The other three, whose conditions were more serious, had to be monitored carefully. But, surprisingly, none had to give up sport. Which is good news for all those amateurs who might agree in principle with a screening programme – but are not convinced they would want to know they have a ticking timebomb inside their chest. “It’s important for all people to have the choice to be tested,” stresses Cox. “It’s a personal choice, but by having the knowledge that they have a condition, they can reduce the chances of a cardiac event occurring.”

Some conditions, he explains, are treatable with an operation; others might need drugs to regulate; while others might simply require a certain amount of lifestyle modification.

But while the majority of people with an undiagnosed heart condition have no symptoms, it’s important to look out for things like exercise-related chest pain and fainting for no apparent reason, both of which could be signs that all is not well. “Then you have other symptoms like palpitations, breathlessness which is more than should be the case for what you’re doing, and dizziness,” says Cox.

If you’re worried about these or other symptoms, ask your GP to refer you for an ECG, see www.testmyheart.org to find out where there is a screening programme near you, or contact the National Stadium Sports Medicine Centre (0141-616 6169, www.sportsmedicinecentre.org).

“The UK NHS policy is that screening should not be offered,” says Cox. “However, we believe that is discouraging young people who may be at risk of sudden cardiac death having what are simple, non-invasive and potentially life-saving tests.”

• www.c-r-y.org.uk