When the heart gives up

TVScope Leargas - The Heart of the Matter RTÉ One, Monday, 5th December, 7.30pm

TVScope Leargas - The Heart of the Matter RTÉ One, Monday, 5th December, 7.30pm

Sudden adult death syndrome (Sads), the subject of RTÉ One's Leargas next Monday night, is up there with the worst of those dreadful thieves who we've come to expect like strangers in the night.

Under the umbrella of sudden cardiac arrest - those deaths that occur within one hour of the onset of symptoms due to cardiac causes - it takes its place, among others, on a panel of pain and loss alongside sudden infant death syndrome (Sids), sudden heart failure and the inarticulate prose that signatures "he just dropped dead" or "she took a massive heart-attack".

As is now widely known, Cormac McAnallen, a 24-year-old teacher, was the captain of Tyrone and a skilful gaelic footballer with the best years of his life ahead of him, when tragedy struck inexplicably in March 2004.

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In the programme, his brother, Donal, offers useful insights into his brother's being and personality, and recalls the events that led up to and include that fateful night, recording the whole sense of incredulity and disbelief.

And Cormac's mother and father, Bridget and Brendan, offer a parent's poignancy recalling the early medical inaccuracies that lay the blame for their son's sudden death at the feet of ambition, burn-out and over-training, that his body was low in body fat and that his body had "started to eat itself", to the final postscript of cardiomyopathy.

They also discuss the McAnallen family's joint venture with the Tyrone County Board that aims to provide defibrillators to every sports club in Tyrone and, eventually, across the country. Automatic external defibrillators (AED) cost €2,500.

Sudden cardiac death is caused by coronary artery disease, cardiomyopathy and channelopathy, with the last two more prevalent in people under 50 years of age, and is generally arrested through screening or prompt defibrillation.

Screening includes charting a family and personal history, an electrocardiogram, an exercise test and 24-hour holter-monitoring.

Defibrillation is where a device gives an electric shock to the heart helping to replace cardiac arrest with normal contraction rhythms.

The medical introspection is provided by consultant cardiologist Dr Joe Galvin, who underlines the difficulty of pinpointing a syndrome that occurs in one in 150,000 men and one in 750,000 women, arguing, in the circumstances, that the method of detection is possibly employing an inadequate screen.

He also acknowledges that the lack of hardcore data on sudden cardiac deaths is caused by an archaic system that refuses to countenance the reporting of the syndrome on death certificates, thus at a stroke undermining the accountancy.

Highlighting a number of the less-talked about inadequacies in our health service, Galvin sees ambulance response times as "frankly unacceptable", given that AEDs need to be with a patient within five minutes of collapse. Possible in Dublin, not so in the country.

The programme also investigates the recent curtailment of Conor Phelan's inter-county hurling career with Kilkenny after doctors discovered a leaky valve in his heart.

Phelan's condition only became apparent, when, after the young Kilkenny full-back Noel Hickey came down with a viral infection that affected his heart earlier in the year, the Kilkenny County Board took the decision to test the other squad members.

It was from these tests that Phelan was strongly advised that his health wouldn't withstand the rigours of top-class hurling.

A massive blow to any young man, the 22-year-old hurler talks about the difficulties of believing that beneath a healthy fit exterior lurks a killer in wait.

The programme, produced by Karen Rodgers and presented by Fachtna O'Drisceoil, also features interviews with Cormac McAnallan's team-mates and friends, Kilkenny manager Brian Cody, and further medical insights are provided by Kilkenny team doctor, Dr Tadhg Crowley.