The Disorder That Killed One Soccer Player And Incapacitated Another

The past month has been emotionally tough for the world of soccer. Two professional players, both in their early twenties collapsed during games in front of thousands, if not millions, of fans and television viewers. Fabrice Muamba, representing English team, Bolton Wanderers, was technically dead for 78 minutes but was miraculously revived and survived. Piermario Morosini, while playing for Italian team, Livorno, was not so lucky. He fell to the ground some time before half-time, tried to lift himself up to his feet before crashing down again—this time, forever. These two incidents occurred only a couple of weeks apart.

Those dreadful incidents sparked a lot of debate at the highest levels of soccer governance: How could young and seemingly healthy athletes die so suddenly? Are the periodic health tests and monitoring performed by the clubs adequate?

Both Morosini and Muamba suffered cardiac arrests although more detailed information is unlikely to be released due to privacy reasons. However, the most probable cause of such sudden deaths in young people is a genetic disorder known as Hypertrophic Cardiomyopathy (HCM). The condition affects an estimated of at most 1 in 500 people.

Morosini and Muamba likely had small "mistakes" in their DNA. Scientists call those mistakes mutations. Mutations are not evident most of the time, let alone life-threatening. But in rare cases, mutations can transform genes into killers. At least 50 mutations are associated with HCM. They occur in genes that code for muscle proteins and cause continuous growth of cardiac muscles beyond normal sizes. The cardiac muscles eventually become so thick that they start to prevent blood flow in and out of the heart, effectively suffocating the organ. The lack of blood deprives the heart of oxygen resulting in cardiac arrest.

HCM is a sudden and unexpected killer. Worse still, it is also a silent killer. Unfortunately, while the heart slowly compromises itself, symptoms are practically inexistent. Indeed, most people are asymptomatic and sudden death may be the first manifestation of the disorder.

It is, of course, difficult to detect a predominantly asymptomatic disorder such as HCM. But there are two sides to this coin as some people do exhibit some symptoms linked with abnormal functioning of the heart. Screening can detect such subtle symptoms in first-relatives of afflicted people or in those who have a history of recurrent heart failures.

Since HCM is relatively uncommon though, it is essential to first and foremost raise awareness of the disorder. And what better medium than soccer itself to do so. In the wake of last month's incidents, the highest levels of soccer governance have a responsibility to educate soccer players about HCM. Just as well, soccer is also the most popular sport on the planet and a sensitization campaign has the potential to reach millions (or even billions) of people across all continents. They have done large-scale sensitization campaigns—such as those against discrimination and doping—before so clearly the expertise is there.

Last weekend, Fabrice Muamba made a highly emotional appearance at the Reebok Stadium, Bolton's home ground. He was applauded by both Bolton and Tottenham fans, their opponent of the day. As the camera swirled around him to capture this intense moment, one could not help but pray that the only matter of life and death in soccer occurs during penalty shootouts.

Image credits: Top: Brianza2008 (from Wikimedia Commons); Bottom: Ronnie Macdonald (from flickr).

Update: 03 May 2012 (1307 EDT): Polished post and corrected typos.