by Gabriele Bronzetti
The umpteenth death of a young athlete due to cardiac arrest on the pitch is a warning so that it never happens again. To achieve this, however, we must apply the laws that already exist and implement a serious prevention program: echocardiogram before the age of 12 and resuscitation course starting from middle school.
April 14, 2024 Mattia Giani, 26-year-old Castelfiorentino striker, immediately after shooting on goal he collapsed on the Campi Bisenzio pitch due to a heart attack which led to his death the following day. Exactly 12 years earlier, on 14 April 2012, the Livorno player Piermario Morosini had fallen in the same way, in breaking latest news. Two 26-year-old footballers die on April 14 from heart disease, 12 years apart. At this point the superstitious person thinks that being part of a Tuscan team, being 26 years old and playing on April 14th brings bad luck, while the ultra-denier shouts that these sudden deaths are due to the Covid vaccine (even if 12 years ago there was none ).
The truth is that in both cases we could have done more with early diagnosis and timely resuscitation (the Eriksen case at the 2021 European Championships is exemplary). I don’t believe in coincidences, I call them connections. If there is someone who touches wood, I stick to the numbers and not out of superstition, but because the numbers are geometric “metaforms” that measure the world, giving meaning and harmony to the fiery ball that passes between our legs.
The time it takes to save a life
Let’s take the number 12 then.
There are 12 traces of a standard electrocardiogram.
12 seconds is the duration of an electrocardiogram sheet.
12 minutes is the time needed to rule out significant heart disease with an echocardiogram.
12 years is the age at which a good part of the submerged pathologies potentially causing cardiac arrest – cardiomyopathies, arrhythmogenic channelopathies, myocarditis – can be diagnosed with an electrocardiogram, echocardiogram, magnetic resonance imaging, CT scan, Holter-type ECG monitoring, etc.
12 years is the age at which many sports become competitive and for which Sports Medicine requires particular certifications.
12 February 2004. Inter-Juve are played at San Siro for the semi-final of the Italian Cup. Near Padua, Emanuel, 16 years old, a Del Piero fan is watching the match on TV. In the 33rd minute of the second half Del Piero scores. At that moment his heart stops. He can die of joy and as it will be discovered, for an arrhythmia that is revealed with an exercise test and confirmed with a genetic test.
12 years is the age of a girl who recently in Florence during a cardiopulmonary resuscitation simulation, without any training, recognized a cardiac arrest, then grabbed a defibrillator and used it correctly in less than a minute. It is known that with a stopped heart after 10 minutes brain death is certain; every minute that passes the probability of salvation drops by 10% and therefore the first 3-5 minutes of resuscitation are golden.
Golden minutes
Golden minutes that become thousands of years of life if we think that every day in Europe a thousand people have cardiac arrest. With proper resuscitation, 30% of these could be saved.
Primo Levi in The Drowned and the Saved wrote: «If understanding is impossible, knowing is necessary, because it has happened and can happen again». 12 years after Morosini’s death it happened again: you can have a cardiac arrest on a pitch without receiving adequate assistance, despite the law requiring defibrillators (AEDs) in sports facilities and despite the so-called «law of the good Samaritan” (n.116 of 4 August 2021) authorizes non-healthcare workers to use the AED without criminal consequences.
It is not decent to learn that the defibrillator arrived late, when there should be one every hundred meters and anyone should be able to use it. If this is the man then we need the extra man, that twelfth man that is fabled in football or, the game plan that aims at numerical superiority without opponents being sent off. The extra man in the team would be given number 12, the reserve goalkeeper: someone who almost never plays but that one time he enters the pitch saves your life and the game. Like a defibrillator on the bench.
If not now, when?
The last 12 is that of Samuele: he was 12 years old when on 14 February 2019 in Arsiero, in the province of Vicenza, collapses while playing football. The defibrillator arrives late. The autopsy will discover a congenital anomaly of the coronary arteries that can be diagnosed with an echocardiogram. Samuele was born on Christmas Day and mockingly died on Lovers’ Day, which is also and not by chance World Congenital Heart Disease Prevention Day: if this isn’t a warning…
If not now, when? As Primo Levi said, knowledge is essential for the error and horror not to be repeated. If we do not make an echocardiogram possible before the age of 12, a CPR course between middle school and driving school and more, we will prove that artificial intelligence is not a threat, but a necessary natural selection. And so the Sapiens, forever and ever, on February 14th, will be able to continue unwrapping chocolates with ridiculous love phrases.
*Head of Pediatric Cardiology, Sant’Orsola Hospital, Bologna
April 18, 2024
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