Alive and Kicking?
September 3, 2007
DW-WORLD.DE: Professor Kindermann, two soccer players died suddenly of heart attacks in recent weeks, and another was just barely saved. Is this coincidence -- or is there something more going on?
Wilfried Kindermann: Above all, I think it is a coincidence. The fact that soccer is the top sport worldwide adds to the chances: The more people there are playing the sport means there are that many more who can die of a heart attack while playing it. In the USA, for example, many more athlete deaths take place during basketball and football games. But if you look at injury and death relative to the number of people who play a given sport, then things look entirely different: relatively mild activities like bowling and golf are at the top of the roster when it comes to sport-related death.
But the people who died last week were professionals; young athletes who were even under medical supervision. You would think they were particularly healthy, and unlikely to die of a heart attack.
Yes, there are people who appear healthy, but who either weren't examined at all, or who weren't examined well enough. These sudden deaths are almost always due to some underlying illness. In young athletes, for example, there is almost always inborn heart-muscle hypertrophy, malformed coronary arteries, or myocarditis.
Should the doctors who were supervising these players be accused of not keeping a close enough eye on their charges?
Well, first you have to know whether they were examined at all. Hypertrophy can be easily diagnosed with an ultrasound. In German soccer we have a very good system. All players in the first and second German soccer leagues have a heart check before each season.
Everyone knows that doping is particularly damaging to the cardiovascular system. Can we rule out that the two players who died were involved in doping?
Doping can, indeed, lead to heart damage -- arhythmia, and sudden death from heart attack. But it is really difficult to test for doping after someone's death. In most cases you can rule it out, but you can't always prove it after a death.
There were 15 deaths in competitive soccer in the last 10 years. How many cases are we talking about worldwide?
So if I want to go kick a ball around with my buddies after work tonight, I should go to the doctor first?
After a certain age, you should know about the state of your health. Right now we hold to the basic rule that anyone over 35 should have a checkup if they plan to do sports. But I have to also make it clear that doing sports, per se, is healthy. And people who are active have a smaller chance of dying of a heart attack than someone who is not. In Germany there are 100,000 sudden deaths from heart attack each year -- and almost none of them have to do with sports.
In the 1960s you were a competitive athlete. Were you examined back then?
Oh, yes, I can remember it exactly. I was a 400-meter runner and had to pedal a bicycle ergometer while lying down. The doctor was surprised by my relatively weak performance.
Wilfried Kindermann, born in 1940, was a member of the team that won the gold medal in the 4x 400-meter relay race in the European Athletics Championships in 1962. Today he is one of the Germany's leading sports-medicine authorities. He has been the chief physician of Germany's National Olympic Committee (NOK) for seven Olympic games; chief physician at FIFA Confederation Cup 2005 and Soccer World Cup 2006, a member of the Medical Committee of the European Football Association (UEFA); Deputy Chairman of the German Football Association's (DFB) Commission on Sports Medicine; internist for the German National Football Team 1990-2000; and member of the scientific advisory committee of the German Heart Association. Kindermann heads the Institute for Sports- and Preventive Medicine at Saarland University.