Friday, July 30, 2021

Dr Bogwasi dissects cardiac arrest in footballers

Dr Lone Bogwasi, chairman to Botswana Football Association (BFA) medical committee, is certain they have everything under control.

Responding to the association’s readiness to deal with the potential cardiac arrest risks due to the coronavirus, he said they have put in place measures to safeguard lives of players.

According to an infectious disease doctor at Standford University, research has shown that as many as 20 percent of people who recover from covid-19 tend to show cardiac abnormalities.

In addition to the research doctors have long suspected Covid-19 to also affect the heart. This being the heart muscle cells, which the virus uses to enter cells. 

Speaking on the matter, Bogwasi confirmed that research has indeed proven the worst side of Covid-19 through its side effects. 

With regards to football, he said sudden collapses associated with cardiac arrest are now a common happening. This he said can result in a successful resuscitation or an unfortunate event of death for an athlete. 

“The most common cause of death in sudden cardiac arrest is Hypertrophic cardiomyopathy or HOCM (structural), others may be electrical or conduction abnormalities. It is not so common in football but when it does happen it is tragic,” he explained.

Bogwasi said in the case of Covid-19, the virus induces the inflammatory response leading to raised cardiac markers (Troponin T, CK-Mb, N-Terminal pro-brain natriuretic peptide), diffuse pulmonary infiltrations, diffuse electrocardiography (ECG) changes consistent with myocarditis.

To ensure that players are safe from cardiac arrest, Bogwasi stated that BFA has existing pre-competition medical cardiac screening, which includes checking players’ medical history, physical examinations, chest x-rays, ECG or ECHO/ Cardiac MRI if ECG is not normal will be undertaken.

“This has been a practice in the preseason period every year. This time verification will be done for every team in the premier league and First division before competitive games start. Medical training will also be availed to regions and medical personnel of teams will be sensitised on these,” Bogwasi explained.

While these tests are not failproof and do not prevent cardiac arrest, Bogwasi said they enable them as doctors to pick up the avoidable causes of sudden cardiac arrest like HOCM or heart blockage due to construction abnormalities.

On the potential effects of Covid-19, Bogwasi said: “When the corona virus is in its moderate to severe form it may affect the respiratory or cardiac system. Intensive screening will be carried out just as BFA described their return to play medical guidelines. Post infection, further testing and a gradual resumption of activity has been advised so as to pick up any complications resulting from the Covid-19 infection.”

Given the risks associated with Covid-19, the BFA medical committee chairman said a surveillance form will be devised. He said every team will submit the forms weekly to the BFA to give the association an idea of the burden of the virus in teams.

Along with the surveillance form, Bogwasi said there will be a declaration form which will be signed by the medical persons and chairpersons of teams committing to follow the guidelines as stipulated. 

Furthermore, he stated that this will be complemented by the verification of medical reports from all premier league and First division clubs. Upon resumption, structures will also be encouraged to comply through the trained medical personnel of the respective teams.

“Sensitization is key that speaks to regular educational programs and trainings around how to identify, respond and resuscitate a sudden cardiac collapse athlete. An AED will be mandatory in every premier league game to assist in shocking the heart,” he said.

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