You are bound to have seen the news about Christian Eriksen, the Danish football player who collapsed while playing for Denmark against Finland at the European Championships a few days ago. Fortunately, the latest news is that he is now in stable condition and conscious.
Achirawin Jirakamolchaisiri, M.D., a.k.a. Dr. Bright, Business Group Director at the Heart Institute, Pharmacy and Physiotherapy at Bumrungrad International Hospital witnessed the events that day, including the response by the medical teams. As a practicing cardiologist, Dr. Bright only had positive things to report. In fact, he is certain that the actions of those who attended to the player are the main reason he is still with us today.
“I am sure many of you will have previously seen news about athletes dying during competitions or when exercising despite them seemingly being much fitter than the general population, which obviously results in questions about how these things can happen,” the doctor explained.
Dr. Bright is fully aware of what many readers may be thinking, going on to explain that the main reason behind a sudden and unexpected collapse is a lack of circulation from the heart to the brain, which can be caused by any of the following conditions :
- Hypertrophic cardiomyopathy accounts for approximately 30% of such cases and involves the muscles in the walls of the heart becoming abnormally thick, which can result in reduced circulation when under strain or stress, as well as being a major cause of severe arrhythmia. This condition can be hereditary, a result of a genetic irregularity, or idiopathic, although by using an echocardiography, it is possible to detect among athletes – for whom it is more common to see hypertrophic cardiomyopathy. Treatment for this condition can involve surgical removal of the thickened section of muscle or insertion of a catheter used to administer a substance into the thickened muscle that will cause its cells to atrophy, thereby making it less dense. Additionally, tests must be carried out to check whether genetic factors are at play because if patients have a family history of the condition, their relatives must also undergo screening.
- Ventricular arrhythmia results from severely disrupt to the normal pattern of electrical signals, such as ventricular fibrillation or ventricular tachycardia. Patients with these types of conditions do not generally experience symptoms that precipitate screening, meaning they lead normal lives, can exercise like anyone else, and may even show no signs of a problem despite undergoing a health check-up. Exceptions are patients with a family history of deaths caused by idiopathic heart failure, as they may have subsequently undergone genetic screening prior to any symptoms becoming apparent. Treatment for these conditions could involve a defibrillator transplant designed to reset the heart’s regular signals or an AICD transplant used to restore a pulse following arrhythmia.
- Coronary artery disorders are generally associated with coronary stenosis, which tends to occur in the elderly or in patients with underlying health conditions, such as high blood pressure or high cholesterol. However, in young patients or athletes, medical staff will look for congenital coronary artery disorders, such as anomalous arterial origin or anomalous arterial formation.
As you can see, the only potential factor behind sudden cardiac arrest that can be effectively detected prior to becoming symptomatic is hypertrophic cardiomyopathy, with any condition caused by irregular electrical signals in the heart much more difficult to distinguish. Indeed, most patients are only diagnosed following a life-threatening event. Therefore, adequate training for the public in how to provide basic life support to patients in life-threatening situations and critical care training for those in the field of public health or members of staff in other organizations is vital. This is because the most important aspect behind saving the lives of these patients is effective CPR which will partially support circulation throughout the body while the heart has stopped beating. This is especially important for the patient’s brain. Nevertheless, the use of an AED to reset the heart’s signals following a severe arrhythmia episode can also play a key role.
The events witnessed in the European Championships show just what a key role everyone can play in responding to an emergency, in this case, whether it is the teammates who spotted his collapse so quickly and ensured he was kept away from any additional harm, the officials who called on medical staff within 5 seconds of his collapse, or the medical staff themselves, who had clearly undergone extensive training in how to use the vital life-saving equipment at their disposal. I must also complement his teammates for standing in a circle around him to protect his dignity as he was given life-saving treatment on live television shown throughout the world. It is testament to the whole team and the quality of the healthcare provided that we were all able to watch Christian Eriksen lay conscious as he was stretchered off the field and taken to hospital. This conclusion was only made possible because of the preparations, knowledge of life-saving protocol, and effective use of the various medical equipment to hand.
The response to Christian Eriksen’s collapse is a great example to any organization, and indeed Thailand as a nation, of how essential it is to teach athletes and sports clubs about the importance of regular health screening. This is especially vital among professional athletes, who should have an understanding about potential heart diseases that they may be prone to as even the most developed countries cannot detect 100% of heart disorders before they pose a danger. Additionally, it is now clear to see how education and training regarding basic life support can significantly increase the chances of survival should these groups or someone in their family suffer such an accident.
Dr. Achirawin Jirakamolchaisiri,
Business Group Director at the Heart Institute, Pharmacy and Physiotherapy at Bumrungrad International Hospital
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