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While Paris-Roubaix is due to take place this weekend, the male defending champion, Sonny Colbrelli, will not take part in the famous cycling classic. The Italian rider suffered a heart attack three weeks ago while racing. If he could be revived, not everyone is so lucky. In France alone, what is called “the sudden death of the athlete” leads to between 800 and 1,200 deaths each year…
While the Paris-Roubaix cycling race is to be held on Saturday April 16 and Sunday April 17, 2022, the men’s title holder, Sonny Colbrelli, will not take part in the famous classic, nicknamed “The Hell of the North”. The Italian rider suffered a heart attack three weeks ago while racing. If the athlete was able to be revived, not everyone is so lucky. In France alone each year, between 800 and 1,200 people die of what is called “sudden death of the athlete”…
An “unstable heart arrhythmia”
On March 21, 2022, a few meters after the finish line, and just after taking second place in the first stage of the Tour of Catalonia in Spain, Sonny Colbrelli collapsed, unconscious. The 31-year-old Italian cyclist, reigning European champion, has just been the victim of a “unstable cardiac arrhythmia”, explains the press release of his formation, the Bahrain-Victorious, having trained “an episode of loss of consciousness with convulsions and subsequent cardio-respiratory arrest”, specify the organizers of the race.
If Sonny Colbrelli was able to escape death, it was thanks to the medical team on site, who resuscitated him by performing cardiac massage, before using a defibrillator. Transported to the hospital in Girona, the cyclist comes out of it with a big fright, and a battery of exams, which revealed nothing abnormal.
The case of Colbrelli is the typical illustration of what is called “sudden death of the athlete”, that is to say a sudden and unpredictable cardiac arrest occurring during or shortly after sports practice.
About 1,000 deaths per year in France
Unfortunately, not all stories end as well as that of the Italian cyclist, as Alain Fariscot reminds us, who is organizing a rugby fives tournament on April 18 in Ustaritz in the Basque Country, in memory of his grandson, Peio Oyhamburu, victim of a sudden death a year ago, at the age of 17. « Peio was a sporty boy, who played rugby and trained regularly, he had never had heart problems and had a healthy lifestyle.” recalls his grandfather. And yet, one morning in April 2021, while jogging, the young man was struck down by a heart attack.
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Every year, sudden death related to effort kills between 800 and 1,200 people in France, explains Professor François Carré, cardiologist at the University Hospital of Rennes: “The vast majority of cases concern men between the ages of 40 and 50, carrying out a leisure sporting activity. Sudden death cardiac arrest is due to cardiac arrhythmia. The latter complicates a disease that was not known until then. »
“It’s not sport that creates the disease, but it reveals it and can trigger a rhythm disorder, he continues. In men over 40, in 85% of cases, people are victims of a myocardial infarction. Cardiac arrest is then caused by an artery that clogs at the level of the heart because of a plaque of cholesterol, the cells of the organ no longer receive oxygen, and that is when a heart rhythm disorder occurs, creating sudden death. »
Unexplained causes in the youngest
But the fatal malaise can also occur in younger and physically fit subjects. Each year in France, 200 deaths by sudden death related to effort concern young people under 35 years of age. And there, the reasons are often more difficult to find. “Peio’s autopsy did not reveal anything abnormal, we do not know what could have caused his death”, continues Alain Fariscot, who today raises awareness of this misunderstood evil and tries to raise funds to finance research.
“Before 35, it’s more complicated, because there are multiple causes, says Professor François Carré. In six cases out of ten, we find in the aftermath a genetic or congenital disease that promotes the occurrence of arrhythmia. In 10% of cases, it may be myocarditis. It is then a viral disease that causes inflammation in the heart, creating a scar that can cause arrhythmia. And in the remaining 30% of cases, nothing is found. Not because there is no cause, but because our examinations are not yet fine enough…”
A research project
This is why the cardiologist launched in 2019 the research project on the sudden death of the athlete. Title To resolvethis study is supported by the Heart and Research Foundation of the French Society of Cardiology. “It seemed important to us to support such a project and help finance it, recognizes Elisabeth Riboud, general delegate of the foundation. Heart research has come a long way in the last forty years, we think we have discovered everything, but in reality there is still a lot to do. In addition, there is no heart plan at the national level, so cardiovascular pathologies have less visibility compared to other diseases such as cancer or Alzheimer’s, even though they still represent the second cause of death in France. . »
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This is why the Resolve project aims to study all cases of cardiac arrest occurring during a sporting activity. Perform a battery of tests (blood test, MRI, etc.) if the person could be resuscitated, and a thorough autopsy if the person is dead. An essential work to advance research and find the causes of these sudden unexplained deaths, and try to prevent them in the future.
“It is also a way of providing answers to the relatives of the victims, complements the cardiologist. You have to put yourself in the place of the parents of a 20-year-old, for example, who seemed to be in great shape and who is going to die suddenly while playing football or running a half-marathon. Today, we cannot tell them what their son died of. Already, psychologically it is not simple because the disappearance is brutal. And it’s even more difficult if they have other children who also play sports. We know from experience that parents no longer live because they fear it will happen again! »
The importance of prevention
For a year now and the disappearance of his grandson, Alain Fariscot, who is also former president of the Pyrénées-Atlantiques departmental rugby committee, has been raising awareness in the Basque Country about sudden death: “Before Peio’s death, I had never heard of it. I inquired and there are things to do to try to prevent these tragedies. »
During his various interventions, he tirelessly repeats the ten golden rules enacted by the association of sports cardiologists. It also draws attention to the fact of completing with rigor and seriousness the self-health questionnaire requested at each renewal of a sports license for underage athletes. “We must also raise awareness among certain medics who sometimes issue a certificate of non-contraindication a little too easily”, continues Alain Fariscot.
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Indeed, the role of the doctor is essential, recognizes François Carré: “When he is consulted by a sports practitioner, he must ask him all the questions likely to detect if there are symptoms or abnormal things. This examination can detect 10% of cardiovascular pathologies. »
The cardiologist also reminds that the athlete himself has his role to play: “In almost 40% of cases, people who have suffered sudden death have experienced symptoms in the three weeks before the cardiac arrest. It can be discomfort in the chest, unusual difficulty climbing a hill, or even abnormal recovery, sudden shortness of breath… All of these things should alert them and push them to consult. This would significantly reduce these accidents. »
Know the gestures that save
Finally, those around the victim, when sudden death occurs, must also be vigilant and react quickly in case of discomfort. “In 90% of cases, victims of sudden death are accompanied. If the witness intervenes immediately, it increases in a huge way the possibility of survival of the victim, emphasizes François Carré. Because when we provide assistance to a person who has suffered a sudden death, we prevent the sudden death from becoming a permanent death. For this, the population must be trained in first aid gestures. Unfortunately, on this side, there is still a big effort to be made in France, where too many people are able to perform cardiac massage, thus allowing them to wait for the arrival of help. »
And François Carré cites the example of Danish footballer Christian Eriksen, saved by his captain during the last Euro… The athlete, miraculously, has since been equipped with a subcutaneous defibrillator and was able to resume competition. But he had to leave Inter Milan where he played, because Italy prohibits a professional sportsman from playing equipped with such a device.
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Sonny Colbrelli also received the implantation of such a device. Not sure he can continue his career. But for the Italian athlete, the most important thing is that he is alive; he is well aware of being a miracle, and that not everyone had his chance…
To learn more about the Solve project: coeur-recherche.fr
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