'Clubs are failing young players on heart checks'

Harley Street specialist has called for Premier League clubs to overhaul their screening system

A cardiologist who has worked for four Premier League sides said last night that clubs' decisions not to put young players through annual heart screening meant that the symptoms which could lead to chronic heart failure, as suffered by Fabrice Muamba, were going unchecked.

The enlargement of the heart which is the most common cause of such catastrophic collapses tends to occur from the age of 13 to adulthood. But Dr Amanda Varnava, who has worked with Tottenham Hotspur (who yesterday stated they would offer their players extra heart checks), Fulham, Stoke City, West Ham and Watford, said that the current screening system could see a player go unscreened for long periods beyond an initial academy cardiological test at the age of16 or under, as he works his way through the system.

Dr Varnava, a cardiologist for HarleyStreet.com, said that annual cardiological examinations, which have not been introduced at any of the clubs with which she works, has cut incidence of sudden death by 90 per cent in Italy – where every young player between the ages of 12 and 18 complete a questionnaire and undergo an ECG and echocardiograph each year.

The London Chest Hospital said in a statement yesterday that Muamba was showing "small signs of improvement" and that his heart was beating without the help of medication. The statement also said that Muamba was moving his arms and his legs, though his long-term prognosis remained unclear. The fact that Muamba, whom doctors hope has not sustained brain damage, did undergo cardiac screening at Bolton Wanderers, at the start of this season, demonstrates that there can be no failsafe where the heart is concerned. "It is possible to go through screening process and still harbour a lethal condition," said Dr Varnava.

Premier League mandatory annual checks include team doctors listening for heart sounds, murmurs, pulses and arrhythmias. A special cardiological examination must also be carried out as early as possible in a player's career. The Premier League said that it would re-examine the testing system with other authorities in the coming weeks and hope that something might be learnt from Muamba's case, as was the case when Chelsea's Petr Cech sustained a head injury during a match at Reading's Madejski Stadium.

"Some clubs screen once and don't repeat it, but the incidence of sudden death is particularly high in football and in those of Afro-Caribbean descent, added Dr Varnava. "During adolescence there should be annual checks, certainly up to the age of 18 and possibly 21. There is a complete misunderstanding among the public that symptoms are important. There is no link between symptoms and sudden chronic death. The absence of symptoms is no reassurance."

The cost of annual heart screening for an individual player is around £250, which, as Dr Varnava observed, is relatively cheap by Premier League football standards.

The most common heart defect – cardiomyopathy – an inherited condition that causes thickening of the muscle in the heart wall, leaving no space for the blood to be pumped – can be hard to distinguish from "athlete's heart", the enlargement of the heart that occurs as a result of training, which is natural and a sign of fitness. This is especially so in black athletes who tend to have thickened heart muscle and abnormal ECGs. Half of Premier League players have naturally enlarged hearts but two per cent of white players have thickened muscle compared with 15 per cent of black players. Though Muamba remains critically ill, a friend who had visited him – Curtis Codrington– said he had "spoken minimal words in English and French, which is better than nothing".

Muamba's team-mate Kevin Davies spoke of the enduring agony of the Bolton players, who are desperate that he will continue to respond positively as the adrenaline which was helping to keep his heart going was gradually withdrawn. "With what we all witnessed on the day, you are half expecting a phone call with bad news," Davies said.

"We are all amazed that Fab is still in there fighting. It just makes you appreciate life a little bit more. It is pretty sad really that it takes something like that to trigger it. Sometimes you sulk around. I have been sulking at times because I have not been in the side. But when something like that happens it puts everything into perspective."

As of last night, there had been no dialogue between Bolton and the FA over whether the club would resume their involvement in the FA Cup by playing the re-scheduled FA Cup quarter final with Tottenham, possibly next Monday, on the White Hart Lane pitch where the 23-year-old Muamba collapsed.

Asked if any of the players had considered the re-match, Davies said: "No. Not really. There are loads of questions flying about: where's the club going? Are we competing in the Cup? When is the next league game? What has happened to Fabrice is obviously something that is very rare."

Davies had discussed Muamba with the specialist treating him. "Sometimes, [the patient] may well have a normal functioning heart but he may have picked up a virus which can trigger it off," he said. "It sometimes happens with sportspeople. Because they are so fit, when they pick something up they tend not to notice because they are so fit and can shake it off. That can be one of the downsides of being a sportsman. Sometimes these things can happen."

Have you tried new the Independent Digital Edition apps?
Caption competition
Caption competition
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

Bleacher Report

Daily Quiz
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

Day In a Page

Sepp Blatter resignation: The beginning of Fifa's long road to reform?

Does Blatter's departure mean Fifa will automatically clean up its act?

Don't bet on it, says Tom Peck
Charles Kennedy: The baby of the House who grew into a Lib Dem giant

The baby of the House who grew into a Lib Dem giant

Charles Kennedy was consistently a man of the centre-left, dedicated to social justice, but was also a champion of liberty and an opponent of the nanny-state, says Baroness Williams
Syria civil war: The harrowing testament of a five-year-old victim of this endless conflict

The harrowing testament of a five-year-old victim of Syria's endless civil war

Sahar Qanbar lost her mother and brother as civilians and government soldiers fought side by side after being surrounded by brutal Islamist fighters. Robert Fisk visited her
The future of songwriting: How streaming is changing everything we know about making music

The future of songwriting

How streaming is changing everything we know about making music
William Shemin and Henry Johnson: Jewish and black soldiers receive World War I Medal of Honor amid claims of discrimination

Recognition at long last

Jewish and black soldiers who fought in WWI finally receive medals after claims of discrimination
Beating obesity: The new pacemaker which helps over-eaters

Beating obesity

The new pacemaker which helps over-eaters
9 best women's festival waterproofs

Ready for rain: 9 best women's festival waterproofs

These are the macs to keep your denim dry and your hair frizz-free(ish)
Cycling World Hour Record: Nervous Sir Bradley Wiggins ready for pain as he prepares to go distance

Wiggins worried

Nervous Sir Bradley ready for pain as he prepares to attempt cycling's World Hour Record
Liverpool close in on Milner signing

Liverpool close in on Milner signing

Reds baulk at Christian Benteke £32.5m release clause
On your feet! Spending at least two hours a day standing reduces the risk of heart attacks, cancer and diabetes, according to new research

On your feet!

Spending half the day standing 'reduces risk of heart attacks and cancer'
With scores of surgeries closing, what hope is there for the David Cameron's promise of 5,000 more GPs and a 24/7 NHS?

The big NHS question

Why are there so few new GPs when so many want to study medicine?
Big knickers are back: Thongs ain't what they used to be

Thongs ain't what they used to be

Big knickers are back
Thurston Moore interview

Thurston Moore interview

On living in London, Sonic Youth and musical memoirs
In full bloom

In full bloom

Floral print womenswear
From leading man to Elephant Man, Bradley Cooper is terrific

From leading man to Elephant Man

Bradley Cooper is terrific