BY KUNLE SOLAJA.
Even 29 years after, no one could specifically point to the real cause of the sudden collapse on the pitch and the eventual death of Nigeria’s Samuel Okwaraji. After him, there had been similar occurrences, even in other lands.
Last year, Nigeria recorded another of such sad episodes when a player of Kwara United, Saka Abdulazeez, slumped unchallenged and subsequently passed on while training.
WhatsApp platform, “Nigeria Football Support Platform”, simply abbreviated as NFSP and put together by Dr. Tunde Akinbinu, a medical doctor with strong bias for sports medicine, organised an online interview with Dr. Prince Pambo, a sports medicine physician and member of Ghana FA medical committee as well as the CAF subcommittee on cardiology who explained possible causes of athletes suddenly slumping on the field and passing on.
According to the sports medicine expert, “the underlying factor to most of these deaths is cardiac arrest with Hypertrophic cardiomyopathy being the commonest cause.”
He mentioned that more people in the black race than the whites are dying. He explained ‘hypertrophic cardiomyopathy’ as a condition where the heart muscles are thicker than normal leading to a distorted cardiac activity.
Dr. Prince Pambo
“It is imperative to note that conditions such as concussion, hypoglycaemia, dehydration…etc’ can cause sudden collapse on the pitch but they rarely lead to death”, Dr. Pambo explained.
Perusing through available statistics, he concluded that Nigeria has the highest incidence of sudden cardiac deaths.
“The simple reason being that Nigeria has a high population and also a vibrant sports nation. There are triggers to these deaths…but most of them just happen without any triggers.”
He explained cardiac arrest as a phenomenon where the electrical system of the heart is thrown into disarray leading to an uncoordinated beating of the heart. “The heart is therefore unable to pump blood as it’s supposed to, leading to a cessation.”
He also differentiated cardiac arrest from heart attack which is a circulatory problem. According to Dr. Pambo who is also a CAF sports medicine instructor, FIFA National Project leader for football for health and team physician for Ghana’s Black Stars Team B, “in heart attack there is a blocking of blood flow in the blood vessels ultimately leading to arrest.”
He explained further that “heart attacks are not as sudden as cardiac arrest”. Dr. Pembo explained that heart attack gives warning signs such as chest pain, difficulty in breathing, dizziness and so on.
“Cardiac arrest warning signs are extremely similar to those of heart attack, but the signs are immediately followed by a sudden collapse. Unfortunately for most people, the first sign is actually a collapse”.
He also spoke of possible genetic link. “The statistics lay more occurrences on blacks because their hearts especially West Africans have an exaggerated adaptation to physical activity. They have much thicker heart walls which tends to mimic cardiomyopathy.
“Therefore during screening it is difficult to even distinguish HCM from a normal African adaptation.
“Also, for most black players, the first time they get screened is when they’re invited to the national teams. At that stage, it is extremely difficult to advise people to give up sports.
“In the case of ‘whites’, they do screening at an early age which makes it easier to identify children with risk factors and then advise them to give up sports entirely.
“As much as these medical conditions cannot be eradicated, it’s important for stakeholders to place a lot of emphasis on pre season medical screening, improve resuscitation skills, and also acquire modern life saving equipment.”
On prevention, Dr. Pambo remarked that the first step will be a well detailed report of the player’s medical history.
He advised that certain questions should be examined: “Does he get tired easily when playing? Does dizziness occur? Any family history of sudden death?
“From history we do an ECG to assess cardiac function. We progress to do an ECHO or Cardiac MRI. All these investigations should help diagnose cardiomyopathy easily.”
He also advised on exercising the body. “As much as exercise is good for the heart, any one diagnosed with any heart condition should not exercise without consulting a doctor as not all exercises are helpful.