Rant Mode Activated

A 23 year old footballer has a heart attack

This is a personal tragedy, an ordeal for his family and friends.

This isn't the first nor will it be the last young person to die or almost die of a heart attack, there have been other "high profile" tragedies - Terry Yorath's son, Marc-Vivien Foe. Each is a tragedy for the family and their friends.

Congenital Heart Disease affects about 1 in 133 children.  Of which some will be picked up before birth, some shortly after and some as adults.

The tests used at birth would probably not pick up the electrophysiological conditions that lead to many cases of Sudden Adult Death Syndrome (SADS) - pulse oximetry picks up when someones blood oxygenation levels are less than they should be.

An elite athlete is going to probably, and there are always exceptions, going to have a pretty damn good blood oxygen level.

An ECG is used quite often as part of sports tests especially at key points - such as signing up for a new team (the millions spent mean that insurance can tend to insist on these things) or when playing for your country as a teen. But this test doesn't pick everything up, and some conditions are variable.

Congenital Heart Disease affects about 1 in 133 children.  There's aprox an 85% survival rate to adulthood - which by my maths works out that c 1 in 156 adults have congenital heart disease.  There's good evidence that the average person can maintain a network of 150 people - so on average everyone will know 1 person with a congenital heart defect. (http://en.wikipedia.org/wiki/The_Tipping_Point - sorry I lent someone my copy so can't give a better reference mid-rant)

That's not rare, but it is uncommon - compare it with mental health disorders (1 in 4) or cancer (1 in 3)  - so c50 people in your network of 150...

Rare is defined, by EuroDis, as 1 in 2000 people (http://www.eurordis.org/about-rare-diseases).

So where is this rant going?

First up, a 23 year old son of an asylum seeker lies in a hospital bed, hopefully recovering - lets not speculate on various things about his lifestyle or health... If he chooses to put out a statement he or his family will.

Second up, promote sensible screening - but realise it won't catch all conditions all the time.

Third up, to most people 1 in 150 is rare, most people don't get the numbers game at the best of times, trying to explain the difference between 1 in 150 & 1 in 2000 is going to throw them.

Fourth up, think for a second... the paramedics did their job, the ambulance did their job, the hospital did their job and he's got a chance.  If the same happened to me at work that's all I could ask for.

Rant Over




  1. There was a sensible cardiologist on this morning putting it into perspective. He said that ECG and echo are standard in a prem medical. This is likely to be a really rare electrophysiology problem that wouldn't usually been detected unless you really really looked for it.

    I do think its sad that it takes a footballer to get anything noticed in this country. Also, its far cheaper, easier and probably would save more lives if sats were done at birth.

    I keep having the tipping point mentioned to me - your reference is another sign that perhaps I should read it.

    Put the kettle on and breathe x

  2. Yup - the sats should be coming on stream as part of the standard NHS neonate test set this year - they've been revamping the entire set for a couple of years - finnessing them to get them right... Evidence take time unfortuntely.

    Tipping point is a good amalgm of ideas, almost too many at times - I do love some of the ideas though, and his other books are just as good.


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