Just four days after English Premier League midfielder Fabrice Muamba suffered cardiac arrest during an English FA Cup match in March 2012, Indian footballer Venkatesh suffered a similar fate during a match in Bangalore, India.

The 27-year-old Venkatesh, who was playing in a district level league match on March 21, collapsed on the field during the back end of the match.

While 23-year-old Muamba recovered from his mid-match cardiac arrest in a London hospital, Venkatesh did not survive.

In a similar incident in Singapore a week earlier, 19-year-old Temasek Polytechnic student Muhammad Khairil Muhamad Nizam suddenly collapsed halfway through a friendly football match.

He was rushed to hospital in an unconscious state but didn’t survive. Initial reports indicated that he had died of heart failure.

There have been other previous sudden death incidences related to sports in Singapore. In 2011, a 22-year-old Singaporean runner, Malcolm Sng Wei Ren, collapsed and died during the Standard Chartered Marathon Singapore.

Sudden deaths in otherwise healthy and fit sportsmen may be explained by an underlying heart problem, compounded by vigorous physical exertion.

Such underlying heart problems could include:

1. a heart muscle disorder (e.g. abnormal thickening of heart muscles)
2. an electrical problem (e.g. abnormal heart rhythm)
3. an infection weakening the heart muscle
4. a congenital abnormality of the coronary arteries

The first two of these causes often have a genetic predisposition, meaning they may be related to certain mutations. "Given the appropriate stimuli and triggers, all four scenarios could result in ventricular fibrillation – the heart ventricles don’t contract properly, which may cause the heart to stop suddenly," say doctors from the Department of Cardiology, National Heart Centre Singapore​, a member of the SingHealth​ group.

Sometimes, the victim is found to have a family history of sudden death. But sudden cardiac arrest can also occur in healthy individuals without any known pre-existing heart issues and with no known family history of sudden death.

There are screening tests available for the detection of heart muscle diseases and heart electrical disorders. For example, an echocardiogram can detect the former, and 12-lead ECG, the latter.

1. Have your cholesterol levels checked once a year. Excess cholesterol can cause the blood flow to the heart to become blocked or reduced.
2. Get your blood pressure checked yearly. If your blood pressure is persistently above 140/90mmHg and left untreated, it can result in damage to the heart and blood vessels.
3. Control your diabetes and monitor your blood sugar levels.
4. Lose excess body fat, especially around the waist.
5. Exercise regularly to help prevent heart and blood vessel disease. Just check with your doctor first if you have known coronary artery disease or if you’re above 40 years of age and have been inactive.
6. Quit smoking. Smokers have two to three times the risk of non-smokers of sudden cardiac death. In fact, smokers account for about 40 per cent of deaths caused by heart disease in patients who are younger than 65 years.
7. Manage your stress. Prolonged stress may contribute to a heart attack. Emotional stress and tension also cause the body to produce adrenaline, which makes the heart pump faster and harder, and may also cause the blood vessels to narrow down.

Ref: O17