Sudden death still mysterious!

Whether he is a Sunday sportsman or a high-level athlete, any individual practicing physical activity may wonder if he too is not at risk of sudden death when he plays sports. The death of several footballers in front of the cameras leaves the spectators speechless in the face of the brutality of the event and the absence of any premonitory sign: indeed, like any victim of sudden death, cardiac arrest occurs suddenly and the subject collapses.

Sudden death represents 8.5% of deaths before the age of 35, which represents two deaths per 100,000 people of this age. Sudden death does not necessarily occur during an effort, it can also occur during sleep.

An uncontrollable panic of the heart in question

Several hypotheses can be put forward. But the most likely is the occlusion of a coronary artery (the arteries of the heart). The heart, no longer supplied with oxygen, causes a panic of contractions in a few seconds, and without an electric shock caused by a defibrillator, it stops, unable to suppress what is called “ventricular fibrillation” , that is, the anarchic beating of the ventricles, the main parts of the heart. Death is then immediate.

A tragedy that occurs several hundred times each year

All club officials fear the tragedy represented by the sudden death of an athlete, which does not occur, it must be said, except during a violent effort… Indeed, the occasion of a sometimes trivial effort, in all disproportionate case with the consequences – a healthy individual collapses, dead. And without the immediate intervention of specialized relief, or the presence of mind of rescuers experienced in the technique of cardiac massage, the doctors almost always arrive only to see the fatal outcome. Because stopped, the heart will restart only thanks to a powerful stimulation. The ideal is to have an automatic defibrillator that we are beginning to see in public places. It’s every sports arena’s dream. This is already the case in the United States, where it is found in almost all stadiums, it will probably soon be in France.

But the drama does not strike only in the stadiums, it can be at the bend of a jog in the middle of the countryside, without witnesses, therefore without a net! Or even in the middle of the night: one in three deaths occurs during sleep!

A very difficult event to predict

The Americans, who have a real lead on this subject, are interested in prevention. They published the results of a major survey of close examination of dozens of athletes who died either during or immediately after exercise. At the autopsy, which is systematic, most presented a small malformation of their coronary arteries, these arteries which feed our heart and are responsible for infarctions, panic of the rhythm and cardiac arrests, when they are clogged. So the American doctors made a very precise investigation and going back in the history of these athletes, they realized that if 50% of them had never had any preventive manifestations of this malformation, the other half had presented with pains in the chest and slight fainting spells which immediately lead to the suspicion of heart trouble.

Quite logically, their doctors had prescribed additional tests: electrocardiogram and monitoring of the heart during a pedaling test on a bicycle, what is called the stress test. However, all these examinations were strictly normal. The study therefore concludes that in the face of any suspicious symptom in an athlete, it is imperative to perform a cardiac ultrasound in addition to these examinations. This is the only simple way to highlight the malformation of the coronaries. And if this malformation exists, then the cessation of competition will be imperative and immediate surgical intervention to offer these potential convicts a normal sporting existence.

However, physical activity is recommended even for cardiac patients in their recovery!

Indeed, the latest recommendations, born from the progression of knowledge in cardiology, have just completely changed the dogma which, for years, had condemned cardiac patients to immobility. For example, in coronary artery diseases, in the past, virtually no patient was able to receive a medical certificate for the practice of a competitive sport. Today, a coronary patient who has undergone an intervention which consists in dilating his clogged arteries is authorized, 6 months later, to practice normal physical activity. The new guidelines identified each type of sport for each heart condition.

Learn the cardiac massage technique

In the absence of a defibrillator, which is beginning to be found in all public places, external cardiac massage can restart the heart, or at least continue feeding the brain while waiting for help to arrive, and one wonders why one out of 5 French people, compared to 2 out of three Swedes for example, is able to do them. There are many places where you can learn, with the Red Cross or the fire brigade. It is a civic duty while not forgetting that 9 times out of 10, it is on someone we love that we will have to act.

An extremely important notion: even if you have never learned, you must at least press very hard in the middle of the chest, with both hands. To the rhythm of the BeeGees’ “Staying Alive” music. Don’t smile! This is the official rhythm defined by American cardiologists. French cardiologists are beginning to recommend Michel Sardou’s anthem: the Connemara Lakes!