All athletes are expected to be in tip top shape. By doing that, they will be able to keep up with the competition and strive to win what they are challenging for. Despite this, they remain vulnerable to various illnesses and health risks. A primary factor is some sort of heart disease. The leading cause is a heart attack. This strucks more athletes than initially believed.
What has hit the headlines recently is the passing of a South African rugby player, Cornal Hendricks. He has passed away at the age of 37; due to a heart attack. The 37-year-old reportedly suffered a massive heart attack on Wednesday. Hendricks made his Test debut in 2014 and went on to earn 12 caps for the Springboks, scoring five tries.
Domestically, he represented Boland, the Cheetahs and Bulls. In 2016, Hendricks signed a two-year deal with Western Province and the Stormers, before being diagnosed with a serious heart condition that prevented him from playing for them.
A deal with French Top 14 side, Toulon, also fell through due to his diagnosis and he retired from rugby aged 27. In 2019, Hendricks’ improved health saw him make a comeback with the Bulls where he earned 115 caps and scored 34 tries across all competitions during a five-year stay.
"Many people were shocked and sad when his career was cut short in 2015," said Bulls director of rugby, Jake White, on Thursday.
"When we had the opportunity to get him back on the park, he took that with open arms and made a remarkable use of his second lease in professional rugby. We all witnessed him leave no stone unturned as he inspired his teammates and the South African community through his story of hope and courage."
"It was a privilege and honour to have been his coach, a fantastic role model for the next generation and his appetite for life was infectious. Rugby has lost one of the good ones today. Everyone’s thoughts at the club are with Cornal’s family, friends and his peers during this incredibly difficult time."
"We are deeply saddened and still trying to come to terms with the passing of Cornal, a loved member of the Loftus family who was more than a talented player," said Bulls CEO, Edgar Rathbone. "He knew how to deliver just about the right dose of energy to help lift a room, he was an iconic teammate, a friend for many seasons, and an inspirational figure in the locker room."
"A brother, a son and an inspiration to both the old and young. A man with such an infectious smile that brightened our world, and above all, we knew Cornal as a proud dad to his young kids. We offer our heartfelt condolences to his family, his wife, children and everyone else who is affected by his untimely and tragic death. A special player who defied all the odds and became our inspiration for everyone, may he rest in perfect peace."
Sudden cardiac arrest is an electrical malfunction that causes the heart to stop abruptly. It’s different than a heart attack, which is a circulatory problem caused by a blocked artery (The Science of Health, 2023).
A number of conditions can elevate risk of sudden cardiac arrest in young athletes:
- A genetic disorder called hypertrophic cardiomyopathy (thickened heart muscle) is the most common cause.
- Inherited or congenital conditions of the heart or blood vessels that can reduce blood flow or affect the heart’s electrical impulses. A follow-up evaluation of Bronny James showed that a congenital heart defect likely caused his cardiac arrest.
- A blow to the chest that occurs at a particular point in the heartbeat cycle may cause the heart to stop, a condition called commotio cordis.
Sudden cardiac arrest causes the person to lose consciousness and stop breathing. It’s frequently called sudden cardiac death because many patients don’t survive. Quick response with CPR and especially with an automated external defibrillator is critical to restoring the heart rhythm (The Science of Health, 2023).
Male athletes are at higher risk than female athletes and Black athletes are at higher risk than athletes of other racial groups. It’s also more common in basketball and football than other sports.
Often there are no warning signs, but sometimes athletes may experience symptoms during physical exertion:
- Dizziness
- Shortness of breath
- Chest pain
- Unexplained fainting
Family history of sudden cardiac arrest increases chances that a young athletes may have a similar heart problem. The American Heart Association and American College of Cardiology recommend a 14-item screening checklist that covers personal health, family history and potential symptoms during exercise (The Science of Health, 2023).
An electrocardiogram can detect some heart problems that may put an athlete at risk but they are not a good predictor of sudden cardiac arrest and are not recommended as routine screening (The Science of Health, 2023).
During sport seasons especially football or marathon, sport-related cardiac sudden death has been reported occasionally. Although it might seem to be uncommon for athletes who are physically fit, this fatal event can happen to anyone at anytime. The answer remains unclear why this life-threatening condition could suddenly kill athletes who had never presented any signs and symptoms of cardiac disease (Bangkok Heart Hospital, 2017).
It has been widely acknowledged that exercise is an effective tool for improving health. Exercise has been strongly associated with beneficial changes in cardiovascular risk factor including blood pressure, lipids, insulin sensitivity and body weight. Numerous studies have consistently shown an association between moderate aerobic exercise and decreased risk of coronary heart disease (CHD). Although the health benefits to exercise are well-documented, patients diagnosed with cardiac conditions who engage in exercise and athletic competitions may, on rare occasion, experience sudden cardiac death (Bangkok Heart Hospital, 2017).
Sudden cardiac death is the most common medical cause of death in athletes, with an incidence of approximately 1 in 50 000 to 1 in 300 000 athletes per year according to the most recent estimates in these recent 10-20 years. The risks and causes of sudden cardiac death vary based primarily upon the athlete population. Although rare, sudden cardiac death in the athlete is a traumatic event that has a large impact on society. Sudden cardiac death in the young has a devastating consequence on families, care providers and the community. Sudden cardiac death is a tragedy at any age and under any circumstances but is perhaps most tragic when it claims the life of the athlete, the individual who epitomiSes health and a healthy lifestyle (Bangkok Heart Hospital, 2017).
Cardiac muscle tissue or myocardium is a specialised type of muscle tissue that forms the heart. Cardiac muscle contracts and releases involuntarily. It';s responsible for keeping the heart pumping sufficient blood to supply the whole body; including the brain. Cardiomyopathy is a heart muscle disease that makes it difficult for the heart to pump. There are different types of cardiomyopathy. The most common heart muscle disease that causes sudden cardiac death in athletes is called hypertrophic cardiomyopathy (HCM) – a disease in which the heart muscle becomes abnormally thick. The thickened heart muscle makes it harder for the heart to pump blood sufficiently to the rest of the body. Nevertheless, heart muscle typically becomes thicker in athletes without clinical abnormalities (Bangkok Heart Hospital, 2017).
To screen and diagnose accurately, advanced diagnostic tools e.g. echocardiogram and highly expert sport cardiologists are crucially important. An echocardiogram is a diagnostic cardiac ultrasound. During the test, ultrasound (high-frequency sound waves) from a hand-held wand placed on the chest provides pictures of the heart’s valves, chambers and structure and helps evaluating the pumping action of the heart. Not only screening by echocardiogram but other medical history e.g. underlying disease and family history of cardiovascular disease must be also used to evaluate risks of sudden cardiac death (Bangkok Heart Hospital, 2017).
The most effective tool to greatly reduce risks of sudden cardiac death in athletes is a screening program, particularly for professional athletes who have to participate in the competitions which continuous trainings are required. Screening protocol for prevention of sudden cardiac death in athletes typically includes a physical examination and medical history e.g. underlying disease, family history of cardiovascular disease, previous abnormal signs during exercising or playing in the field including shortness of breath, unconsciousness, dizziness, palpitation and sudden chest pain. Tests to screen include an electrocardiogram (ECG) and echocardiogram (Bangkok Heart Hospital, 2017).
An automated external defibrillator (AED) is a portable electronic device that can be used to automatically diagnose the life-threatening cardiac arrhythmias or irregular heart beat. AED treats the abnormal heart rhythm through defibrillation which is the use of an electrical shock to reset the electrical state of the heart, allowing the heart to re-establish an effective rhythm. Unlike regular defibrillators installed in the hospitals, AED requires minimal training to use. Since it's designed to maximize the convenience, it is portable and easy to carry. Only applying the AED pads on the chest of the patients, it automatically diagnoses the heart rhythm and determines if a shock is needed. With simple audio and visual commands, AED is created to be simple to use for the layperson (Bangkok Heart Hospital, 2017).
In sport, there exists a term known as Athlete's Heart. Athlete’s heart is the name for the changes that happen in your heart when you do strenuous exercise for more than one hour on most days of the week. Most of the time, these changes aren’t excessive. However, in some athletes, the changes can make your heart look similar to how it looks when you have a form of cardiomyopathy. It's because cardiomyopathy isn’t harmless that your provider needs to know what makes athlete’s heart different (Cleveland Clinic, 2022).
Your body needs more oxygen when you exercise. To meet this higher demand, your heart’s left ventricle handles more blood and a higher pressure than normal. Your left ventricle pumps oxygen-rich blood to your aorta, which sends it out to your body (Cleveland Clinic, 2022).
After meeting your body’s need for more blood and oxygen for a while, your left ventricle starts to get bigger and develop thicker heart muscle. When you’re not working out, your heart doesn’t have to pump as much blood. It can pump what you need at a lower heart rate. This is why people with athlete’s heart syndrome have a heart rate that’s lower than a non-athlete’s heart rate at rest (Cleveland Clinic, 2022).
Intense endurance training or strength training can be athletic heart syndrome causes in some athletes. Endurance sports tend to increase the size and wall thickness of an athlete’s left ventricle.
Sports that can lead to athlete’s heart include:
- Rowing.
- Swimming.
- Cross-country skiing.
- Cycling.
You don’t need treatment for athlete’s heart syndrome. However, your healthcare provider may ask you to stop training for three months and reimage your heart to ensure you don’t have cardiomyopathy (Cleveland Clinic, 2022).
In most people, your heart returns to a normal size after you stop training so hard. However, a study found that 20% of former athletes still had a large left ventricle five years later (Cleveland Clinic, 2022).
I find it somewhat ironic that exercising can lead to death. I was always under the belief that excersing is only a good thing. It's truly sad that people can die at a young age as a result of this activity. The good part is that it can be identified and treated. There's also the posibility that it can be prevented from happening all together. These tests should be done at it's earliest stage to avoid catastrophes from occuring.
Reference List
Bangkok Hospital. (2017). Sudden cardiac death (SCD) in sports: the most common medical cause of death in athletes. Available from: https://www.bangkokhospital.com/en/bangkok-heart/content/sudden-cardiac-death-scd-in-sports-the-most-common-medical-cause-of-death-in-athletes (Accessed: 15 May 2025).
Cleveland Clinic. (2022). Athlete's Heart. Available from: https://my.clevelandclinic.org/health/diseases/23920-athletes-heart (Accessed: 15 May 2025).
The Science of Health. (2023). Why Some Young Athletes Suffer Cardiac Arrest. Available from: https://www.uhhospitals.org/blog/articles/2023/10/why-some-young-athletes-suffer-cardiac-arrest (Accessed: 15 May 2025).