HUB's LIST of medical fun facts

Sudden cardiac arrest among fans is a well-documented occurrence at exciting sports events.

• Two fans dropped dead this summer as the Argentina soccer team beat Netherlands in a 4-2 shoot out to break their 0-0 tie. The 16 year old boy collapsed in front of a giant TV screen the mayor had set up in the village square as the winning goal was scored. The 49 year old died during the post-game celebration.
• A 2010 European study of 190 major soccer arenas revealed that there was 1 sudden cardiac arrest in the stadium every 5-10 matches.
• An American study of heart attacks after the 1980 and 1984 Super Bowls showed that, on the day of the game and for several weeks after, men had 3 times the number of heart attacks then expected; a jump from 1 to 3 in 100,000. Further analysis showed that the rate was higher in the fans whose favorite team lost and was lower in fans whose team won!

The presumed mechanism is the outpouring of adrenaline during peaks of excitement which causes heart muscle to go into contractile spasm or ventricular fibrillation. Either one is lethal if not stopped. The European study felt the problem was significant enough to make 6 recommendations for soccer stadiums to ensure that stricken fans could get immediate access to life-saving medical care.

Is there anything that you can do to reduce your risk? Unless you are already taking daily aspirin to reduce your risk of a heart attack DON”T start now. Aspirin has real risks of causing intestinal bleeding AND, truth be told, there is NO evidence that daily aspirin prevents your first heart attack (“primary prevention”). Its beneficial effect is well proven only in reducing the chances of you having another one (“secondary prevention”).

Alcohol is a well-known contributor to high blood pressure (not the best thing for a heart), so if you are truly worried you could take that rather drastic step.

Us coach potatoes can take some solace in the fact that we are not the only ones with increased risk for sudden cardiac arrest.

• Endurance athletes (“continued exercise for 3 hours or more”) have about the same risk, 1 in 50,000, of acute heart attack or sudden cardiac arrest within 24 hours of completion. (1)
• A 1999 study of 38 Austrian athletes in a 143 mile bicycle race with 18,000 feet of altitude change revealed that 34% of them had elevated heart enzymes in their blood at completion; an absolute sign of heart muscle damage. The winner had the highest level! (2)
• A subsequent study of participants in the Hawaiian Ironman Triathlon found that 11% had signs of heart damage at the end. Of course, this is not new. Remember that Pheidippides, the first marathon runner, dropped dead just after delivering his message.

It is interesting that these studies involved only men. Because heart attacks are still the number one killer of women and that 46% of the last Super Bowl audience were women, perhaps it is time to broaden the study population.

I used to collect articles about the dangers of running in order to support my resistance to popular peer pressure at the time, so I am personally heartened to know that the risk for sudden cardiac arrest during a sporting event is about the same for both couch potatoes and players.

References:
1.  Jour Am Coll Card 28:428, 1996
2.  Am Jour of Card 87:369, 2000

This entry was posted on Saturday, January 31st, 2015 at 4:09 PM and is filed under current events, evidence-based medicine, heart health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.