Topic: Is there a link between playing sport and sudden cardiac arrest?

[Shadow Of A Doubt]

So several footballers in the past few years have had heart attacks and died on the pitch while playing football, so I was wondering if the physical exertion on the heart for 90 mins might be a causal factor. Or is it just random chance?

[David E.]

The combination of physical stress and steroids/HGH is a bitch on the heart.  Heart issues kill wrestlers at a pretty out of the norm rate as well.

[Johnny Slick]

I don't know... random clumping also occurs. I remember there being a little spate of this happening to basketball players in the late 80s/early 90s (Hank Gathers, Reggie Lewis, former basketball player Pete Maravich) which amounted to, well, not a lot more than just dumb luck. I appreciate that this looks like a pattern but finding patterns whether they actually exist or not is what humans do.

[Karyn]

Effedra did it for a lot of athletes until it got banned.  It wouldn't surprise me if there was a black market for it still.

[Tatyana]

People typically have to have some sort of cardiomyopathy for this to occur.

Italy actually screens all of the athletes for these inborn errors to avoid sudden death.

They have to screen A LOT of athletes to prevent one death, but I guess they think it is worth it.

[Tatyana]

Effedra did it for a lot of athletes until it got banned.  It wouldn't surprise me if there was a black market for it still.

Yes, people use it for fat loss.

Link about the Italian screening program:

http://www.nejm.org/doi/full/10.1056/NEJM199808063390602

Screening for Hypertrophic Cardiomyopathy in Young Athletes

[Karyn]

I used effedra for a few months before they banned it and dropped from 135 to 105lbs.  The 'recommended' dose gave me chest pains, and I would average over 100bpm.  I could see how it would cause heart problems with prolonged use.  I found I could take 1/4 of the recommended dose and do all I wanted to do, like lift weights for 2 hours.  I loved that stuff.

[lonely moa]

Tom Simpson carked it on le Ventoux near the finish... amphetemine.  I'd be surprised if there wasn't a few more.

[Plastique]

and I would average over 100bpm.

Shit, that must have been quite alarming in itself.

[Jolimont]

Even if professional soccer players stayed away from steroids and boosters of all sorts (and they don't), prime time for a heart attack is when the body is stressed, like, say, when late for work on a Monday morning or for a big meeting. The stress of a critical game must be overwhelming. Still, most professional sports people, even those who run a lot, don't drop dead, so it's probably bad luck.

[Karyn]

and I would average over 100bpm.

Shit, that must have been quite alarming in itself.

Not to me at the time.  Mostly because I was young and ignorant.

[Tatyana]

I used effedra for a few months before they banned it and dropped from 135 to 105lbs.  The 'recommended' dose gave me chest pains, and I would average over 100bpm.  I could see how it would cause heart problems with prolonged use.  I found I could take 1/4 of the recommended dose and do all I wanted to do, like lift weights for 2 hours.  I loved that stuff.

One of the problems with ephedra is something we found in our lab.

Ephedra is still available in Chinese herbal medicine in the UK, it is often called, 'little yellow pills'.

One day the endocrinology consultant was seeing a woman (who came in with her husband) about the issues she was having with high blood pressure. He asked her if she was taking anything, ANYTHING, including supplements, and she would always deny it.

At one of her following appointments, she came in without her husband, and said 'Well, when I said I wasn't taking anything, it wasn't true, but I didn't want my husband to know I have been seeing a Chinese herbalist for weight loss'.

Yes, it was 'little yellow pills' which were listed as basically being ephedra.

However, we did some HPLC on these tablets and found that they were highly contaminated with a banned amphetamine called fenfluramine, or fen-fen.

http://en.wikipedia.org/wiki/Fenfluramine

Fenfluramine caused irreversible heart valve disorders.

This woman was lucky in that she didn't suffer any permanent damage.

Our head of department wrote this article:

Risks associated with herbal slimming remedies

Original article by: C Corns, K Metcalfe

Reference: Journal of the Royal Society for the Promotion of Health, Dec 2002, vol. 122, no. 4, p. 213-219
Source: Journal of the Royal Society for the Promotion of Health

Date published: 20/02/2003 00:00
Summary

The market for non-conventional, natural herbal medicines is growing. This marketing opportunity has been seized upon by some unscrupulous practitioners to sell potentially unsafe 'herbal' products. Several people attended a Chinese herbalist for weight loss advice and were sold 'herbal' preparations that contained fenfluramine, a drug which was withdrawn from sale in the West in 1997 after its use was linked to primary pulmonary hypertension and valvular heart disease. Adulteration of Chinese medicines with Western drugs is becoming an increasing problem, and deaths have been reported from Japan and other Far Eastern countries linked to Chinese slimming aids containing N-nitroso-fenfluramine. There is a need for increased public awareness of such risks associated with the use of unlicensed medicines; a system of registration for medical herbalists is also required to protect both the reputable practitioners and the general public.

We also did a few other investigations looking for other contaminants in Chinese herbal remedies, it was quite common.

I wouldn't be surprised if some of the ephedra that killed people had been contaminated.

Another issue with A LOT of sports and weight loss supplements is that they are just a huge pile crap, so some of the first batches of the supplement are purposefully contaminated with actual pharmaceuticals, anything from diuretics to steroids.

If you are a drug tested athlete, and you really don't want to take any performance enhancing drugs, you steer clear of all supplements as it would be quite easy to accidentally take something and fail a drug test.

[Karyn]

You can't get effedra in any form over here.  I'm not sure if the pills I was taking had anything else in them, but they certainly weren't sold as Chinese herbal medications.  I wasn't a skeptic at the time, and I had no idea how bad and unregulated most supplements were at the time.  As much as I loved them then, there is no way you'd get me near any of that stuff now.  As it is, I don't trust much that is marketed for 'sport enhancement' even over the counter.  It's so hard as a layman to dig my way through the marketing bullshit and real studies.  I figure if I lift weights, do some cardio, eat mostly meat and veggies, I'll probably come out just fine.

[Tatyana]

You can't get effedra in any form over here.  I'm not sure if the pills I was taking had anything else in them, but they certainly weren't sold as Chinese herbal medications.  I wasn't a skeptic at the time, and I had no idea how bad and unregulated most supplements were at the time.  As much as I loved them then, there is no way you'd get me near any of that stuff now.  As it is, I don't trust much that is marketed for 'sport enhancement' even over the counter.  It's so hard as a layman to dig my way through the marketing bullshit and real studies.  I figure if I lift weights, do some cardio, eat mostly meat and veggies, I'll probably come out just fine.

People still buy it on line.

The diet 'stack' is ephedra or ephedrine (which is preferable to most), caffeine and aspirin.

You would be shocked at some of the things I have seen people on bodybuilding sites put in their bodies.

Ephedra and ephedrine is children's candy in comparison to some of the really dangerous things some people will take, for example, stage one or two clinical trial drugs, for example, myostatin monoclonal antibodies.

The one that scares me the most is when people take, DNP, or dinitrophenyl for weight loss.
 
http://en.wikipedia.org/wiki/2,4-Dinitrophenol

[Karyn]

You can't get effedra in any form over here.  I'm not sure if the pills I was taking had anything else in them, but they certainly weren't sold as Chinese herbal medications.  I wasn't a skeptic at the time, and I had no idea how bad and unregulated most supplements were at the time.  As much as I loved them then, there is no way you'd get me near any of that stuff now.  As it is, I don't trust much that is marketed for 'sport enhancement' even over the counter.  It's so hard as a layman to dig my way through the marketing bullshit and real studies.  I figure if I lift weights, do some cardio, eat mostly meat and veggies, I'll probably come out just fine.

People still buy it on line.

The diet 'stack' is ephedra or ephedrine (which is preferable to most), caffeine and aspirin.

(click to show/hide)

You would be shocked at some of the things I have seen people on bodybuilding sites put in their bodies.

Ephedra and ephedrine is children's candy in comparison to some of the really dangerous things some people will take, for example, stage one or two clinical trial drugs, for example, myostatin monoclonal antibodies.

The one that scares me the most is when people take, DNP, or dinitrophenyl for weight loss.
 
http://en.wikipedia.org/wiki/2,4-Dinitrophenol

Not in the USA.  They've been replacing it with 'bitter orange' and 'green tea' and claiming those are fat burners.  Ephedra and ephedrine have been illegal here for many years.