2023-04-26 17:46:46
“Sport is good for your health in the vast majority of cases. But in rare cases it can also be fatal », warns Dr. Denys Barrault, former president of the French Society of Exercise and Sports Medicine (SFMES). As the name suggests, Sudden Athlete Death refers to the sudden death of a person during or shortly after intense physical activity. It is usually caused by heart conditions such as cardiac arrhythmia, cardiomyopathy, or congenital heart defect.
The latest high-profile incident? The footballer’s Christian Eriksen, 29-year-old Danish footballer, suffered a heart condition in the forty-second minute of a Euro 2020 match between Denmark and Finland. Massaged and defibrillated quickly, he narrowly escaped death and was able to benefit from an implantable automatic defibrillator (ICD). Proof that it is absolutely essential to know the gestures of first aid.
Definition: what is Sudden Athlete Death?
Sudden athlete death is relatively rare, but can be particularly shocking because it often affects young people, in good physical shape, even in excellent health. Specifically, it means unexpected and instantaneous death more or less seasoned athletes who collapse in the middle of a physical effort – or a few minutes / hours later.
In question ? A unexplained heart failure. “The general public speaks of ‘heart attack’, but this does not correspond to a medical reality. It’s too vague, ”says Professor Jacques Mansourati, cardiologist, head of the cardiology department at Brest University Hospital and member of the French Federation of Cardiology (FFC). And to specify: “This accident may be linked to a myocardial infarctionto one heart diseaseto one heart failure or even to cardiac arrest “. In any case, the heart can no longer perform its function of perfusing vital organs, such as the brain.
Impact: some figures and statistics
According to the French Federation of Cardiology, more than 500 athletes die each year from cardiac arrest during physical exertion (source 1). Most often it is athletic young men. But the number could be much higher in reality, as Dr Barrault explains: “when the Samu is called for a cardiac arrest on the public highway or in a stadium, it does not necessarily mention the fact that it is occurred during physical exertion. The statistics therefore potentially hide many deaths – including among “Sunday sportsmen”.
Symptoms: What are the signs of sudden death? How do these heart attacks happen?
You will have understood it, it is impossible to anticipate the occurrence of sudden death.
At the time, it may manifest as a sudden loss of consciousness (person suddenly collapses for no apparent reason) and cardiorespiratory arrest. Lying on the ground, the victim no longer reacts and has no pulse. Before collapsing she barely has time to feel chest pain, dizziness or lightheadedness.
Some risk factors should be monitored:
- of the cardiac history ;
- of the Athlete’s history of sudden death ;
- of the Athlete’s family history of sudden death ;
- taking illegal products and of substances dopantes ;
- etc.
In addition, certain parameters are suspected of favoring the occurrence of heart failure: significant stress, overwhelming fatigue, too much heat or too much cold, dietary disorders, dehydration, electrolyte disturbances or even a viral disease.
Is sport really medicine?
Causes: Why do athletes have “heart attacks”? Do they necessarily die younger?
“Sudden Death may concern all athletes, whatever their age, level or favorite sport (basketball, football, swimming, cycling, etc.),” says Dr. Barrault. The causes of sudden death, however, may differ depending on the age of the victims.
Before the age of 35, it is often cardiac arrest that is the cause. “It may be due to a congenital heart defectto one hereditary heart disease or at acquired heart disease which was not known to the patients”, specifies Professor Mansourati. And the older patients get, the more likely they are to face myocardial infarction, he adds. Concretely, one of the coronary arteries becomes clogged and the corresponding area of the heart is suddenly deprived of blood – and therefore of oxygen. She suffers and is damaged, which can lead to ventricular fibrillation and cardiac arrest, explains the expert.
And his colleague to continue: “cardiac causes are the most formidable, but there are also endocrine causes, in particular related to the hormones of the adrenal glands (adrenaline, ephedrine, etc.)”. Aruptured cerebral aneurysm or a spinal cord injury may also be involved.
It also happens that no cause is formally identified, underlines Dr. Barrault, who specifies that the cardiac causes remain the most formidable and the most “easiest” to detect upstream.
Moreover, whatever the age of the patients, the risk is also aggravated by the smokingexcess cholesterol, overconsumption of alcohol, or the lack of regular physical activity.
Sport: can doping increase the risk of death?
Drugs, illicit substances and stimulants such as cocaine and anabolic steroids, can actually damage the heart and increase the risk of sudden death, experts say.
What is the prognosis once the first symptoms have appeared?
The sudden death of the sportsman Eastunpredictable and can occur during or after intense physical exertion. The prognosis of victims depends on several factors, including:
- the underlying cause of sudden death,
- the effectiveness of the resuscitation measures immediately undertaken
- and the time elapsed between the accident and resuscitation.
“It must be admitted that the prognosis of the victims is generally bad, especially if resuscitation is not undertaken immediately or if the underlying cause is not treated quickly and effectively,” warns Dr. Barrault. And to qualify: “However, with rapid and appropriate medical intervention, it is possible improve chances of survival and reduce brain and/or heart damage ».
Prevention: how to avoid the sudden death of the athlete?
Prevention of sudden death in athletes involves in-depth screening beforehand, especially in high-level athletes, regularly monitored by sports doctors and cardiologists. “It goes through the mandatory completion of a electrocardiogram (ECG), a bilan de performance and a cardiac assessment including, in particular, a stress test,” says Professor Mansourati.
In the event of an anomaly, several additional examinations may be prescribed, such as a cardiac ultrasound. And the discovery of a heart defect formally contraindicates the practice of sport in competition, says the cardiologist. “Sunday athletes should also pay attention to their heart condition and carry out a medical check-up before starting to jog to lose a few pounds,” he insists.
Key prevention actions
If no test can really anticipate cases of sudden death, certain habits make it possible to limit the risks and the number of deaths:
- warm up well beforehand ;
- stay hydrated before, during and after exercise;
- do not do intense physical exercise in case of fever ;
- NO SMOKING before, during or after sports practice – and even not to smoke at all;
- do not use doping substances ;
- etc.
Above all, be transparent about your health: report any unusual symptoms to your doctor, insists Dr. Barrault. He is there to accompany you and allow you to evolve in complete safety.
How to react if you witness a heart failure?
Knowledge of the risk factors and compliance with preventive measures unfortunately do not always prevent the occurrence of sudden death… It is therefore essential to be trained in first aid gestures in order to be able to act quickly.
Have you witnessed the discomfort of a loved one or a stranger in full physical activity? Start by checking whether the person is conscious and breathing normally. If this is not the case, it is necessary to take action quickly.
“The care must be as fast as possible to limit the irreversible sequelae. Whatever the situation, do not hesitate to act, it’s always more effective than not trying “, insists Professor Mansourati.
Contact the emergency services (15 or 112)
Do not wait a second before contacting the emergency services. At the other end of the line, a SAMU regulator will ask you questions to get a clear idea of the situation.
Try to keep your cool and tell him the address of the place and the circumstances of the accident, the state of the victim and the first aid actions that are being carried out. The dispatcher will guide you as best as possible while waiting for help to arrive.
Above all never hang up until the dispatcher tells you to ! Note: during major sports competitions, doctors are generally present on site.
Start cardiac massage
Start the cardiopulmonary resuscitation (CPR) as soon as possible. Concretely, this consists of performing chest compressions to help the heart “restart”.
Even if you are not sure of your gesture, get started!, insists Dr. Barrault. Inaccurate CPR and a few broken ribs are better than no CPR.
Follow the advice of the French Federation of Cardiology (FFC):
- Lay the victim on their back on a hard surface;
- Put your knees against the victim, on the side;
- Place your hands on top of each othera little below the middle of the thorax, arms stretched out;
- Press with all your weightwell perpendicularly above the body of the victim;
- The pressures to be exerted are strong: push the hands 5 to 6 cm into the chest and completely relax the chest between each compression.
- Apply pressure to a rate of 100 per minute (the same rhythm as that of the song “ Staying Alive » des Bee Gees)
- If necessary, take turns with the other people present while waiting for help to arrive.
Use an automatic external defibrillator (AED)
Quickly ask a member of the assembly to get an automatic external defibrillator (AED). In France, since January 1, 2020, all establishments that can accommodate more than 300 people must be equipped. In addition, there are now many applications for geolocating nearby AEDs.
These small portable devices can, via two electrodes placed on the chest, send an electric shock to the heart and restart it. “They don’t send an electric shock only when necessary, says Professor Mansourati. And if the electrodes are placed incorrectly, the only risk is that the device will be ineffective”.
Since 2007, anyone can use it, even without training! The devices take care of guiding us vocally, step by step.
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