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Flightless Bird, American Mouth - Iron & Wine

Wednesday, August 29, 2007

[::..Never SAID Goodbye...::]

Many people in this world are fortunate enough to be able to say goodbye to their loved ones before their last breath. But a few of them, never got the chance. One of those few is Antonio Puerta a footballer playing for Seville. He died yesterday at the tender age of 22 after suffering a series of 'heart attacks' and multiple organ failure. He collapsed on the field, got up again, walked to the changing room and collapsed again. He was resuscitated, and never regained consciousness from then on. He was brought to the hospital where he was supported by life support machine and passed on 3 days later. He was going to be a father in a few weeks time. For many of you who are well versed in the game of football, they way he collapse in the field while playing, was similar to the way Marc Vivien-Foe, Miklos Feher and Sergihno collapsed.

Reports in the papers stated that Antonio died of permanent brain damage and multi organ failure due to prolonged and multiple cardiac arrests. But why, a young, fit healthy man would suddenly arrest?

It was reported that Antonio was suffering from Arrhythmogenic Right Ventricular Dysplasia (ARVD). ARVD is a disease that describes itself. An arrhythmogenic, right ventricle that is dysplastic. Arrhythmogenic means prone to ventricular arrhythmias or rhythm disturbances that would require defibrillation to restore to normal rhythm. Right Ventricle is one of the cardiac chambers in our heart that pumps deoxygenated blood into our lungs via the pulmonary arteries. And dysplastic in layman term means: useless/pointless/non-existent. Or scientifically, the muscles of the right ventricle has been infiltrated by fibrous fatty tissues making it inefficient in pumping blood. Pathogenesis of ARVD is largely unknown, but it is known that apoptosis (programmed cell death) is a major cause.

ARVD is seen predominantly in males. 30-50% are inherited. It is usually inherited in an autosomal dominant gene. Which means the gene does not have to be homozygous in order to be expressed. In simple words, you do not have to inherit the gene from both parents. As long as you have 1 part of the gene, it may be expressed. (It has been such a long time since I touch my genetics books! don't get me started. I love the field of genetics).

80% of people with ARVD will present with either syncope (fainting, loss of consciousness) or cardiac arrest. Otherwise, the milder presentation would be palpitations. Clinical signs of ARVD are normally during adolescence. And symptoms are usually also exercise related. I suppose, everyone who is into competitive sports should go for ARVD screening.

Life, so strong, and yet so fragile. Death, seems so far, but so certain. We all should be asking ourselves, in what state do we want to die? For death is so certain, it could be knocking on our door anytime.

Our thoughts will be with the families who lost their loved ones.

Issues on Sudden Cardiac Death are my biggest interest in life. As long as this heart is beating, it will always seek the hearts that are not.

Farah-Cardiac Physiologist (Electrophysiology/Pacing)




"Love is a many splendid thing."

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