Why did a young footballer drop dead?

Centenary Institute’s Prof Chris Semsarian available for comment on sudden cardiac death in young athletes.

Two fit, young professional footballers – apparently completely healthy – have suffered sudden heart attacks mid-match in recent weeks.

On Saturday, 25-year-old footballer Piermario Morosini died at an Italian game, and a month ago, 23-year-old Bolton player Fabrice Muamba was technically dead for 78 minutes before being revived by doctors.

While the cause of Morosini’s death hasn’t yet been revealed, the most common cause of this kind of sudden death is hypertrophic cardiomyopathy (HCM), which could affect up to one in 500 people.

Prof Chris Semsarian is an expert in sudden cardiac death in young people.

He is the head of molecular cardiology at the Centenary Institute, a professor of medicine at the University of Sydney and a cardiologist at the Royal Prince Alfred Hospital.

He’s available for comment

He can explain why young athletes with this genetic mutation are particularly prone to heart attacks, and why their death can be so sudden.

The cause of Morosini’s death has not been revealed (or possibly even determined), but statistically, the most likely cause is an underlying genetic heart disease. A mutation in one of our 23,000 genes can lead to a variety of heart diseases that can affect the structure, function, and electrical rhythm of the heart.

The most common cause of this kind of sudden death is hypertrophic cardiomyopathy (HCM), which affects up to one in 500 people.

Fit, young athletes’ hearts work a little differently from the majority of people. Their well-exercised hearts adapt to the pressures of constant, vigorous training. HCM causes the thickening of the heart muscle. Initially this may give athletes a “super heart” leading to sporting excellence.

But a genetic abnormality causes the heart to continue growing, until the muscle wall becomes so thick that it begins to restrict the flow of blood to and from the heart.

Tragically, genetic heart diseases are often silent, as individuals have no symptoms. Even more sadly, sudden death can be the first presenting symptom in up to half of young people who die suddenly.

Prof Semsarian says it’s possible to screen young athletes for possible heart conditions, but that screening has some limitations. The tests can be expensive, and there are sometimes false negatives, and false positives which might see children wrongly prevented from enjoying sport.

A national screening program exists in Italy, but most countries rely on sporting clubs, programs and institutes to run their own.

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