Helping to make hearts healthy
Niamh Cahill looks at newly established mobile cardiac screening service Heartaid and examines how it is helping to detect potentially life-threatening cardiac conditions in senior inter-county GAA players.
It is estimated that at least one person under the age of 35 dies suddenly every week in Ireland from cardiac diseases such as cardiomyopathy or sudden cardiac death syndrome (SCDS). However, the lack of accurate statistics has meant that it is still unknown exactly how many people die from SCD syndrome and how Ireland compares to other countries in terms of prevalence. A report titled, “Sudden Cardiac Death in the Young”, published late last year by the Sudden Cardiac Death in the Young Registry at the Mater Hospital examined incident rates between 2005 and 2007. It found that 119 confirmed SCD cases occurred between 2005 and 2007 – 75 per cent of which occurred in men.
The incidence of SCD in those aged between 15-35 years in Ireland was 2.68 per 100,000 a year. “The incidence rates in this report may be an underestimation of the true figure due to missing or inadequate data resulting in case exclusions,” the report states. “The incidence is higher than in other similar European studies performed in Iceland and in Sweden. The reason for this is unclear and requires further investigation.” The registry, established in 2008, will conduct studies for the years 2008 onwards and has recommended that “a national standard protocol for the performance of postmortems in cases of SCD should be agreed and implemented”. As efforts continue at a national level to accurately record the number of deaths from SCD, Heartaid, Ireland’s first private dedicated cardiac screening service, is providing screening to more than 2,000 GAA players.
By the end of the year it is envisaged that all senior intercounty GAA players will have been given the opportunity to undergo potentially lifesaving cardiac screening. Based in Cork, Heartaid (www.heartaid.ie) is conducting screening at the behest of the Gaelic Players Association (GPA) and has so far screened more than 19 teams and over 500 players. Founder and Director of Heartaid, Mr Ed Donovan, explained that one or two players from each team is usually found to have an abnormal ECG, heart murmur or simply something in their family history that suggests they may need to go for further investigation. Mr Donovan has never been directly affected by SCD, but developed an strong interest in the area through his work in healthcare management. “The more research I did the more I thought there was a need for screening.
I thought if I can make it accessible and affordable and with the right medical people it would work,” he told IMN. Mr Donovan attends every screening along with a GP, medical doctor and cardiac technician. Each player is asked to fill out a questionnaire to obtain as much information as possible about their health and level of physical exercise. A physical examination is subsequently undertaken where blood pressure and other measurements are taken to search for signs of cardiac diseases or irregular heart rhythms. Some of the risk factors include fainting and blackingout for unknown reasons and a fast heartrate that comes and goes, even when resting. Taking part in sports does not cause SCD but physical exercise can trigger a previously undetected heart problem, causing sudden cardiac arrest. Heartaid has also conducted screenings in golf and hockey clubs and the service may undertake screenings in schools in the future.
Aside from sporting clubs, Heartaid also operates a screening clinic once a month in Cork City where individuals concerned about SCD can receive information or be screened. Cork-based GP Dr Ed Donovan, Mr Donovan’s father, has conducted screenings at the clinic and told IMN that about 70 per cent of attendees are male. He maintained that a lot of concerned parents make appointments for their children to be seen at the clinic due to a concern about SCD and the fact that inherited cardiac disease is known to cause cases of SCD. He opined that screening is essential for everyone participating in any type of sports activity and especially for those who have a family history of cardiac disease. Mr Donovan went even further and suggested that “based on research in other countries it definitely warrants consideration that it be mandatory” in Ireland. In Italy, cardiac screening is mandatory for anyone taking part in organised or competitive sports. This has led to a reduction of up to 89 per cent in SCD, Mr Donovan remarked. “If the same situation existed in Ireland and it was mandatory the results could be similar to Italy,” he said.
The possibility of screening becoming mandatory unfortunately seems like a distant prospect, however. Last month Health Minister James Reilly stated that the Department of Health had no plans to create a scheme for grants to purchase automated external defibrillators (AEDs). In response to a Parliamentary Question on the matter by Independent Deputy Tom Fleming, he stated that, “my Department does not propose to introduce a scheme for grants to be made available for the purchase of defibrillators or other such equipment. Acquiring concrete data on SCD remains a priority and its benefits cannot be outweighed. The “Sudden Cardiac Death in the Young” report stresses that accurate data is essential to “assist health care planners to understand the potential impact of genetic testing facilities and national family screening services, and to examine any change in disease frequency over time. “Furthermore, such knowledge of the burden of SCD in a country will assist in improving awareness of this lethal condition for health care providers, coroners, and pathologists, as well as for the general population themselves.”