by ZodWa KumaLoVaLentIne

Why does a super-fit soccer star like Fabrice Muamba suddenly have a heart attack in the middle of a match?
When 24-year-old Bolton Wanderers midfielder Fabrice Muamba collapsed on the pitch during an English Premier League match against London club Tottenham Hotspur in March, fans around the world were shocked. After all, no one expects a fit and healthy young man to suffer a heart attack. Luckily, Muamba, who fell to the ground 41 minutes into the game, was rushed to the specialist London Chest Hospital, where he appears to be making a good recovery. But the world has been asking, how does this happen to a sportsman, were there any warning signs and will he be able to play football again? Though heart attacks seem to happen out of the blue, theyre often the result of a gradual process over a number of years. A heart attack occurs when the arteries become too narrow, caused by the build-up of fatty deposits (atherosclerosis), or a clot forms, thereby restricting the blood flow to the heart. The heart muscle then becomes deprived of oxygen, which results in a heart attack. South African? cardiologist Dr Tom Mabin says its impossible to comment on why someone as young as Muamba had a heart attack without knowing the exact details of his medical history. However, he almost certainly suffered from a cardiac arrhythmia, rather than a classic heart attack. Certain cardiac arrhythmias can be potentially fatal unless expert medical help is available immediately, as in this case, he says. A lethal cardiac arrhythmia would be more likely in someone with a history of previous cardiac problems. However, there are certain rare conditions that can cause this in otherwise perfectly healthy young individuals, who are often athletes, says Dr Mabin. Some of these conditions can be detected with simple clinical examinations, ECG and ultrasound, and, importantly, may be suspected if there is a history of premature sudden death in the family. Heart attacks in young people are rare and not usually related to coronary artery disease, adds Dr Mabin. As in the case of Muamba, they are caused by sudden changes in the heart rhythm, causing the heart to stop working, and they are usually due to genetically inherited abnormalities in the heart.

Sudden heart attacK

The most common is called hypertrophic cardiomyopathy (a part of the heart muscle becomes thicker, making it harder for blood to leave the heart), and is three times more likely in men than women, and more common in men of African descent.

It happened to me
Entrepreneur and property developer Hentie van Wyk had his first heart attack at age 26, and then a second when he was 35. During my first heart attack I was sick and fainted for a few seconds. With my second one I could not breathe and was gasping for air. After my second heart attack, doctors were unable to open the vein that had stents put in after my first heart attack, and so I suffered multiple anginas [chest pain due to lack of blood and oxygen supply]. This lead me to have a triple bypass. I could not live always wondering when and if I would have another heart attack, says Hentie. Heart attack sufferers who have a history of high cholesterol like Hentie, whose reading was 15 in his mid-teens are predisposed to cardiac problems. Family history is also a red flag. Henties brother has high cholesterol, though he hasnt had a heart attack, and his father has stents in his heart. After his first attack, Hentie went on to receive his Western Province colours in wrestling and a gold medal at the SA championships. But not everyone is as fortunate. The chances of survival in severe heart attacks such as those suffered by Van Wyk and Muamba are extremely low, about five percent, Dr Mabin says. Professor Peter Weissberg, the medical director of the British Heart Foundation, believes Muamba can make a full recovery but its likely he will be advised not to play soccer again. Dr Mabin agrees, adding: He will, however, hopefully be able to live an otherwise normal, active life.

The value of screening individuals, such as top athletes, has been under discussion for years. However, these tests are, generally speaking, not particularly fruitful as these conditions are very rare and often impossible to detect before the event anyway. Dr Tom Mabin
LIFe GoeS on
Damaged heart muscle takes about six to eight weeks to heal. And though scar tissue may be permanent, it will not affect the way the heart functions. Most people need four weeks after leaving the hospital to recover. If your job requires heavy manual work, you may need longer. You should not drive during the first three weeks. When resuming driving, avoid long journeys and heavy traffic. Resting is paramount. With your doctors approval, light exercise can gradually be introduced the best at this stage is walking, cycling and swimming. If you feel shortness of breath, dizziness, weakness or chest pain, contact your doctor immediately. It is important for family, friends and close colleagues to know if you have heart disease, and what to do if a heart attack or arrhythmia occurs. Everyone can benefit from learning more about the warning signs of heart disease and CPR (rapid chest compressions performed with your hands). Most people will remain on their regular tablets (for high blood pressure, high cholesterol etc??) to reduce the risk of another heart attack, but additional medication might be necessary. There is no reason not to continue normal sexual activity after you have recovered from a heart attack. Dietary changes to support recovery will be made in consultation with a dietician. These include avoiding stimulants such as caffeine and cutting down on alcohol.

Am

hoW to preVent heart dISeaSe

Exercise for at least 30 minutes every day, such as brisk walking, shooting hoops or cycling. Maintain a healthy body mass index (BMI) of between 18.5 and 25. Calculate this by dividing your weight (in kg) by your height (in metres) squared. Example: 80kg (1.75m x 1.57m) = 26 BMI. Eat a balanced diet with lots of fruit and vegetables, and low in saturated fats and salt. Do not skip breakfast. Foods that are especially beneficial include oats, salmon, olive oil, avocado, berries and legumes. Stay away from nicotine and recreational drugs. Drink alcohol in moderation. Monitor your cholesterol, including levels of LDLs (the bad guys). High cholesterol is a measurement of more than 5mmol/L. Consult a specialist if its higher than 7.5mmol/L. Note that pregnancy naturally increases cholesterol levels. Monitor your blood pressure. If it is higher than 120/80, see a doctor and take steps to reduce it. Have your blood sugar tested annually, especially if there is a family history of diabetes. Consider a mineral and vitamin screening test and supplementation. Potassium, magnesium, calcium, selenium, copper and coenzyme Q10 are all essential for heart health. For more info, contact the Heart & Stroke Health Line 0860 143 278 or visit www.heartfoundation.co.za

Risk Factors
Your age simply getting older means more wear and tear on your arteries and heart muscle. Your sex men are generally at greater risk, as are post-menopausal women. Family history especially if the heart problems developed before age 55 for a male relative or age 65 for a female. Smoking nicotine constricts blood vessels, carbon monoxide damages their inner lining. Poor diet too much salt, saturated/solid fat, trans fats (hydrogenated oils) and foods high in cholesterol (egg yolk, liver pt, cheese, shellfish) are the biggest culprits. High blood pressure it hardens and thickens the arteries, thus narrowing them and restricting blood flow to the heart. High blood cholesterol increases the formation of plaques in the arteries, which also restrict blood flow. Diabetes. Obesity being overweight worsens other risk factors. Physical inactivity. High stress it can damage arteries and worsen risk factors. Poor hygiene/dental health viral and bacterial infections can lead to heart problems or worsen an underlying heart condition. Source: The Mayo Clinic

WarnInG SIGnS
Women and men present different symptoms, and thus diagnosis is often only made late. A typical warning sign of an attack in men is heavy pressusre, tightness, unusual discomfort or crushing pain in the centre of the chest, which may spread to shoulders, arms, neck and/or jaw, while about 43 percent of women dont experience chest pain at all. Instead, women feel very tired, dizzy or nauseous, and will experience pain in the abdomen or back. They may also have swollen feet. Other symptoms of an attack (in both sexes) may include sweating, shortness of breath and a rapid, weak pulse or fluttering heartbeat. Good to know: a sharp, stabbing pain in the left side of the chest is usually not heart pain or a heart attack.

photographs gallo/getty images, ????????????

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