Heart of the matter

Fabrice Muamba. Who? Not a question you will hear asked now, although a week ago you would have struggled to find anyone who could tell you that he developed through the Arsenal Academy before transferring to Birmingham City, switching in the summer of 2008 to Bolton Wanderers.
 
He represented several English age-group teams and was being touted as a potential England star of the future.

His miraculous recovery from being effectively dead for 78 minutes has sparked headlines around the world.
 
The response to his cardiac arrest while playing in an FA Cup tie at White Hart Lane has, for once, shown professional footballers and their supporters in a positive light.
 
Witness the disgusting chants from Derby County fans gloating over the death of the owner of Nottingham Forest, the racist chants across Europe, particularly Russia, and the increasing number of petulant and self-indulgent immoral or illegal acts of a large number of players.

Yet Muamba’s tragedy has brought an outpouring of grief, prayers and support from around the world that has been overwhelmingly heartfelt and compassionate.

Fortunately, thanks to the immediate intervention of the professional on-site medical team, not to mention the response of one cardiac-specialist Spurs fan, Fab looks as though he will make a full recovery, although it is too early to say whether he will play again.

However, spare a thought also for Clive Clarke. And D Venkatesh. Some of you may also recall Marc Vivien-Foe. What do these largely anonymous names have in common? They have all suffered the same fate – or worse – as the Bolton No. 6.

Clarke collapsed at half-time in another Cup tie while representing Leicester City who were playing away at the home of archrivals, Nottingham Forest. The swift intervention of the medical team in 2007 saved the life of the 27-year-old Irishman, although he has never played since.

Venkatesh, playing last week in India, was not so lucky. Foe collapsed and died in Lyon while representing Cameroon against Colombia.

Muamba can probably thank the ‘Special One’, Jose Mourinho, for his strong complaint to the English Football Association following an incident in 2006 when his Chelsea goalkeeper, Peter Cech, received a sickening blow to the head.

The current Real Madrid manager was incensed that Cech spent the first 30 minutes ‘lying on a bench in the changing room’ rather than receiving specialist care for his fractured skull.

As a direct result the Premier League introduced regulations requiring the club doctor to attend every match while an ambulance had to be on-site for the exclusive use of the players, with more officials trained in spotting symptoms and administering CPR.

Muamba received two defibrillator shocks on the pitch in front of 30,000 apprehensive fans, and a further 13 in the ambulance in the 48 minutes it took for him to reach hospital.

The high-profile nature of this case may well serve to help prevent the estimated 500 deaths that occur in those aged under-30 while playing sport in the UK alone due to an unknown heart condition.

Premier League players such as Muamba now receive regular medical check-ups, including heart screening.
 
It is believed that Muamba has received four such tests since he was 16, the most recent being last summer. The belief that Muamba is one of the fittest members of the Bolton squad lends weight to the theory that this condition is more to do with hereditary defects rather than a disease or the poor physical condition of the individual.
 
Indeed, it is the youth and fitness of Muamba that is what makes this case so shocking.

In the eyes of Manchester City boss, Roberto Mancini, the medicals conducted by English clubs are too light in comparison to those undertaken by Italian clubs.
 
This is particularly emphasised by the case of Senegalese midfielder, Khalilou Fadiga, who was diagnosed with a heart defect following his arrival at Inter Milan from Auxerre in 2003. He was subsequently cleared to play in the UK, ironically at Bolton.
Italian clubs screen their players every six months and are subjected to far more stringent medicals that, in addition to looking at simple tests of current health, also explore potential conditions that could have been passed on genetically.

Fadiga’s case highlights that even those with a heart defect can continue to compete.

This is not a condition unique to footballers. Further evidence can be found in a book released last week Eddy Merckx; The Cannibal written by his doctor, Daniel Friebe. He recalls an incident during the 1968 Giro D’Italia in which he arranged for Merckx to undergo a new medical procedure, a cardiogram, following a particularly tough stage of this cycling classic. It is claimed that the results for Merckx looked as though he had suffered a heart attack.

Merckx went on to win the race, his first Grand Tour triumph, before claiming a then-record five Tour de France titles. According to the book transcripts he always ‘laughed about the funny results’ from his cardiac tests, yet shrugged them off to become the most successful cyclist ever, based upon his spread of titles and abilities.

Several years later, Italian footballer Renato Curi dropped dead in the middle of a match while suffering from the same condition. Nowadays, Merckx would be banned from racing. Instead, he raced with the sword of Damocles above his head.

Muamba’s case should serve as a warning to us all – to get regular checks rather than to avoid all sport! However, all sports should do more to highlight prevention while also ensuring more staff are fully trained in CPR.

The response at White Hart Lane saved Muamba’s life.