SHAH ALAM - While sports offer numerous health benefits, including improved cardiovascular health and mental well-being, even the fittest individuals face the underreported risk of sudden death.
Regular sports activities can reveal or worsen underlying health conditions, sometimes with fatal results.
These incidents aren't isolated to any particular region; in Malaysia, individuals of all ages have tragically lost their lives during sports activities.
This has become a recurring theme, with news outlets annually reporting similar incidents that deeply impact our communities.
Referred to as the 'silent killer,' sudden collapses occur without warning, leading to numerous reported cases.
In a recent incident at a secondary school marathon in Kuala Pilah in April 2024, a male student collapsed and passed away just 50 metres from completing the seven-kilometre run.
Another incident, reported by Berita Harian in November of the previous year, involved a man collapsing and passing away while playing badminton at the Piasau Sports Complex in Miri.
The deceased, a local man around 51 years old, collapsed during a badminton session with friends.
Research conducted in the United States revealed that 80 per cent of sudden death cases among older athletes, aged 35 and above, were attributed to coronary artery diseases.
Contrarily, younger athletes who succumbed to the same cause were found to have inherited heart diseases.
Cardiac Risks in Athletes
Sunway Medical Centre interventional consultant cardiologist Datuk Dr Yap Yee Guan distinguished sudden cardiac death from heart attacks.
While a heart attack stems from reduced blood flow due to a blocked coronary artery, sudden cardiac arrest results from rapid, erratic electrical activity in the heart.
He reportedly described that many young athletes experiencing sudden cardiac arrest have hypertrophic cardiomyopathy (HCM), characterised by thickened heart muscle, increasing the risk during physical activity.
In a recent Bernama report, it was also revealed that participation in sports is discouraged for those with HCM to prevent complications like dehydration and electrolyte imbalances.
Detection of HCM primarily relies on electrocardiogram (ECG) and MRI scans, although they may not always be sensitive or affordable.
Warning signs include chest pain, breathlessness, palpitations, dizziness, blackouts, and seizures.
A family history of sudden cardiac arrest is crucial for identifying potential cases.
Individuals with a family history of sudden cardiac death or coronary risk factors should undergo cardiac screening before sports participation to mitigate risks.
Emergency Response for Sudden Cardiac Arrest
Sunway Medical Centre consultant emergency physician Dr Ooh Ping Yee emphasised the importance of prompt action to save someone experiencing sudden cardiac arrest.
Steps include activating emergency medical services immediately, performing Cardiopulmonary Resuscitation (CPR) within two minutes by a first responder, defibrillation within two to four minutes using an automated external defibrillator (AED), and early advanced life support within eight minutes.
Quick action significantly improves survival rates, and CPR and AED usage should continue until the patient regains consciousness or receives medical attention from healthcare professionals.
Recommendations for Heart Health
Recent research shows individuals with an unfavourable lifestyle are 78 per cent more prone to premature death, regardless of genetic factors.
There's a concerning rise in sudden deaths among young, apparently healthy individuals, challenging assumptions about youth and fitness guaranteeing longevity.
Universiti Kebangsaan Malaysia (UKM) Public Health Medicine Specialist Professor Dr Sharifa Ezat Wan Puteh highlighted the lack of awareness among individuals regarding their cardiovascular health status.
She recommended regular exercise, calorie management, stress reduction, and sufficient sleep to lower risks of hypertension, diabetes, and heart disease.
She also advises limiting processed foods, sugary drinks, and excessive red meat consumption.
"In addition to maintaining a healthy lifestyle, avoiding high-risk behaviours is crucial for promoting heart health.
This includes refraining from smoking tobacco and using drugs like cocaine, amphetamines, cannabis, and alcohol," she told Sinar Daily when contacted recently.
Causes of Sudden Deaths in Young Individuals
Consultant Public Health Specialist Professor Dr Hematram Yadav stressed that sudden deaths in young individuals primarily stem from genetic or congenital factors, as well as acquired heart diseases.
"These conditions often affect heart rhythm, strain the heart muscle, and disrupt blood flow, potentially leading to death.
"Overexertion, genetic predisposition, and drug use can also contribute to sudden death in young people.
"Approximately 73 per cent of these cases are attributed to cardiovascular causes.
"Lifestyle factors such as diet, sleep patterns, stress management, and training intensity and frequency play significant roles. Regular medical check-ups are necessary," he said.
A robust support system, including consistent cardiovascular and mental health monitoring, is especially important during significant competitions.
Psychological factors, including performance pressure, can impact both mental and physical health, emphasising the need for individual athlete assessment.
Hematram added that exercising at least two hours before bedtime is generally acceptable, but late-night exercise can disrupt sleep and negatively impact heart rate and sleep cycles due to increased adrenaline production.