One of the most startling and unexpected events in sports is the sudden death during the play of a young athlete. Herodotus recorded the death of the Athenian’s fleetest runner, Pheidippides, who had been sent to seek help from Sparta during the Persian invasion; he ran 167 miles to reach the Spartans, the raced back to the Athenians with the news that the Spartans had refused to help. He then fought in the Battle of Marathon, in which the Greeks triumphed over the Persians. As soon as the victory was secured, he ran 26 miles at top speed to bring the Athenians the wonderful news. On arriving, he gasped out his message, “We have won!” and fell down dead-but his feat inspired the 26.2-mile footrace we call the marathon today.
Young male athletes are particularly vulnerable to cardiac arrest as a consequence of several kinds of congenital heart disease which produce fatal arrhythmias during games. A congenital abnormality in the heart’s electrical system (which produces a regular heartbeat and an orderly excitation of the heart muscle) predisposes them to disturbances in cardiac rhythm. These patients can experience sudden death, particularly during competitive sports. Other fatalities are due to a disorderly growth of the heart muscle itself. For example, some parts of the heart’s septum, which is proportionately large and actually prevent blood from leaving the chamber when the heart contracts. There is also an illness called Marfan’s syndrome, in which patients are unusually tall and have weaknesses in the wall of their aorta, which can rupture when blood pressure rises during a game.
Some players who are victims of sudden death during sports events have undiagnosed inflammation of the heart muscle due to a viral illness called myocarditis. Myocarditis was in 6 to 7 percent of competitive athletes6 and 20 percent of military recruits who had sudden cardiac deaths.7 An article by Paul Gardner, who reported on the deaths of three soccer players between the ages of 16 and 26 in September of 2007, points out that about 1,000 players a year die from sudden cardiac death. Exhaustion due to the increased rate of speed of play as well as the higher number of games played by each competitor also can end in a fatal outcome. Gardner quotes the assertion of former French soccer star Michael Platini that soccer is characterized by “a relentless drive to play more games …’ we all want to play less but… the system is made so that the players play more and more.” Body contact is now more severe; the size and weight of players have increased over the past 40 years.
6. B.J. Maron, K. P. Carney et al., “Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy” Journal of the American College of Cardiology 41 (2003): 974.
7. R. Eckart, S. L. Scoville et al., “Sudden death in young adults: A 35-year review of autopsies in military recruits,” Annals of Internal Medicine 141 (2004): 829.