In the next episode in the saga, young defender Anwar Ali appeared before the AIFF Medical Committee on Sunday, October 11 along with his doctor who joined in the video conference from London.
After being stopped from playing by the All India Football Federation last month, Anwar Ali sought the advice of a top expert regarding the condition of HCM in top sportsmen around the world. This is when he decided to consult Prof. Sanjay Sharma who is an authority on the topic of HCM, Sudden Cardiac Death in Athletes and has collect immense amount of data and done thorough research and even conducted many studies on the topic over the past few decades.
Professor Sharma qualified at Leeds University in 1989 and completed his Cardiology training in London. His passion for Sports Cardiology was sparked when he was awarded a Fellowship from the British Heart Foundation to research the Athlete’s Heart in 1997 and his research innovations were subsequently supported by Cardiac Risk in the Young.
He was appointed Professor of Sports Cardiology and Inherited Cardiac Diseases at St George’s University of London in 2010.
He is the Medical Director for the Virgin London Marathon and Consultant Cardiologist for the Cardiac Risk in the Young Sports Cardiology clinic at St George’s Hospital.
As one of the leading Sports Cardiologist in the UK, Professor Sharma he is the Cardiologist for the English Institute of Sport, British Rugby League and the British Lawn Tennis Association. In the London 2012 Olympics he led the medical team for the triathlon, marathon, long distance cycling, open water swim and the 20K walk. He was also the lead cardiologist for the polyclinics during the Olympics and Paralympics.
Professor Sharma has an international reputation in cardiovascular adaptation in athletes, sudden cardiac death in the young and heart muscle diseases and has published over 240 scientific articles including original papers in highly rated peer reviewed journals. Professor Sharma was awarded the status of Fellow of the European Society of Cardiology and elected as a nucleus member of the Sport Cardiology section of the European Association of Cardiovascular Disease Prevention and Rehabilitation in the 2008.
Professor Sharma leads the Cardiac Risk in the Young screening programme, which is the largest of its kind in the UK and is responsible for screening athletes from most GB National athletic squads.
He has an active interest in medical education has published several educational books in medicine and cardiology including the Self Assessment Colour review of Cardiology and Rapid Review of Clinical Medicine, one of the leading resources for doctors preparing for the MRCP Part 2 written examination.
In February 2015 Professor Sharma was awarded 1st Viviane Conraads Outstanding Achievement Award for Established Researchers by the European Society of Cardiology and in 2017 he was awarded a Doctorate from Aristotle University for his contribution to Sports Cardiology.
Prof. Sanjay Sharma is also the Chairman, The FA Cardiology Consensus Panel.
During the meeting Prof. Sanjay Sharma discussed in detail the case of Anwar Ali and answered many queries of the AIFF Medical Panel regarding the complexity and degree of the condition in Anwar Ali.
Prof Sharma pointed out that Anwar would have been cleared to play in England given his condition is totally asymptomatic and has no obvious disqualification factors like family history. He also said that many players with similar and even worse degree of HCM are currently playing in the top competitive leagues in Europe and UK. He also pointed out that the guidelines regarding competitive sports participation with HCM have been reviewed and revised this year itself and are much more liberal than before on cases like Anwar.
In his report Prof. Sanjay Sharma stated, “Anwar does not have any obvious risk factors such as a family history of sudden death from hypertrophic cardiomyopathy, syncope, severe left ventricular hypertrophy or exercise induced arrhythmias or non-sustained ventricular tachycardia on the Holter monitor. His 5 year risk of sudden cardiac death according to the ESC risk calculator is 2.2% (i.e annual mortality risk of just under 0.44%). It is important to emphasise that the presence of left ventricular scar is not incorporated in the ESC 5 year risk calculator, however, the indices that are incorporated (age, syncope, left atrial diameter, left ventricular wall thickness, left ventricular outflow gradient and non-sustained ventricular tachycardia) perform well in identifying high risk individuals. The additional risk of the stresses of exercise on potentially fatal arrhythmias is unknown, however based on a study in deceased Italian athletes compared to the relatively sedentary population, this additive risk is 2.5 times the risk of a relatively sedentary person.11 Based on these figures Anwar’s annual risk is approximately 1% per annum, therefore it may be considered reasonable for him to participate in competitive football.”
For Anwar Ali this support of a top expert is big, but the AIFF medical committee has sought time to study the latest report and then take a final decision.