Professor Sanjay Sharma
Professor of inherited cardiac diseases and sports cardiology, St George's, University of London and St George's Healthcare Trust

Presented by Cardiovascular Sciences Research Centre, St George’s Hospital, University of London, Cardiovascular Sciences Research Centre, St George’s Hospital, University of London and Cardiac Risk in the Young

Exhibit blog

summer-science:

This post is by Alex Orlek, one of our digital volunteers, who spoke to scientists about the Athlete’s heart exhibit.

Professor Sanjay Sharma is having a particularly busy year, not least, taking responsibility for the screening of all British Olympians before the games in order to detect potentially fatal heart conditions amongst our athletes. This week however, Professor Sharma, his colleagues from St George’s, University of London and the charity ‘Cardiac Risk in the Young’ have been working at the Summer Science Exhibition, where visitors can learn about heart health from cardiologists, and even undergo a screening thanks to the on-site electrocardiogram (ECG).

The exhibit Athlete’s Heart focuses on the unexpected heart attacks which can strike apparently young and healthy individuals, often as a result of vigorous exercise. Of course, regular exercise, for the most part, is great for heart health. However, 1 in 300 athletes are thought to have a dormant heart condition which usually only emerges in the form of a sudden exercise-related cardiac arrest.

The most common cause is ‘hypertrophic cardiomyopathy’, in other words, heart disease associated with a thickening of the heart muscle. Professor Sharma’s research focuses on better understanding the changes to an athlete’s heart which result from training, and to distinguish these normal changes from sinister heart conditions, which can appear similar – both involving thickening of the heart wall. 

Further reading

Many sports bodies recommend or insist that young athletes are screened for disorders implicated in exercise-related sudden cardiac death. 1 in 300 of the individuals tested are identified as having a potentially life threatening condition and 1 in 100 are identified with a less serious cardiac abnormality that may cause problems from the middle age.

There are currently approximately 600 cardiac deaths each year under the age of 35 and most (75%) sudden cardiac deaths occur without prior symptoms.

Research from Italy, where cardiac screening is mandatory for people engaged in organised sport, shows that 90% of these deaths could have been prevented if cardiac evaluation using an ECG had been carried out.

How it works

The research behind this exhibit has focused on the structural and electrical functioning of the heart and how it responds to exercise. It has identified the upper limits of left ventricular wall thickness and cavity size in adult and adolescent British athletes. This helps to distinguish between physiology (cardiac adaptation to exercise) and pathology (disease).

This distinction can be challenging for cardiologists but is crucial when screening young athletes since incorrect interpretation has the potential for serious consequences.

The research programme has also been important for understanding what is normal. It has devised normal upper limits for cardiac dimensions in athletes and characterised ECG changes in athletes in a document that is now regarded as the blueprint for the European Society of Sport Cardiology.

Apart from diagnostics, the research has also identified the prevalence of conditions such as hypertrophic cardiomyopathy (HCM) in athletes. This includes recently identifying conditions such as long QT syndrome as more common than HCM. The research team is also the first to have looked at cardiac adaptation for Caribbean athletes who differ from Caucasian athletes in the way they adapt to exercise.

Videos

This video shows Professor Sanjay Sharma giving a presentation on his research at the 2011 CRY International Conference.

This video shows Dr Nabeel Sheikh giving a summary of CRY's cardiac screening procedures for athletes. More information and videos are available on Cardiac Risk in the Young.

Lead image: Matt Wells (GB Rower and Olympic Medallist) having a cardiac ultrasound conducted by Professor Sharma.