‘You’d kind of just presume you’d know if you had a heart condition’: How raising the awareness of cardiac screening can save athletes’ lives

Paul Boyle remembers the date: Friday, January 12th. Before the whirlwind. At training that evening the Antrim hurlers were offered cardiac screening. The Gaelic Players’ Association (GPA) had set it up. A doctor and a nurse were on site. Nobody was forced to do it. Darren Gleeson, the Antrim manager, was committed. Maybe the phrase is soft coercion. Everyone did it.

Two days later Boyle played 70-odd minutes against Dublin in the Walsh Cup. Scored three points from play. At full tilt. A day later he was told to stop.

Jackie called from Advanced Medical Systems. On his ECG something had shown up. He didn’t feel any differently. There were no symptoms that he could tell. He felt fine. In the whole of his health. Young. Fit. He denied everything.

“I said to Jackie down the phone, ‘No, I think it’s wrong,’” says Boyle. “There’s definitely nothing wrong with me. I’d know if I had something wrong with my heart. I would feel it. In my life I never felt anything wrong with my heart. No chest pain, nothing. I told Jackie that I think she’d got it wrong. It must be the wrong reading. There couldn’t possibly be anything wrong with my heart.”

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The Mayo footballers turned up at Castlebar Hospital. By appointment. Second weekend in February. Same deal. GPA. Cardiac screening. By consent. In and out. Done.

The following week a number flashed up on Saoirse Lally’s phone that she didn’t recognise. They kept trying. It was Wednesday before she answered. Advanced Medical Systems. There’s a problem. Lally denied everything.

“I thought the ECG was wrong,” she says now. “I didn’t think something might be up with me. I was still fine, and I went training that night and everything. Then the following day I got another call from a clinic in Dublin saying they’d advise me to get the heart procedure done.

“I kind of didn’t want to know the full extent of it, to be honest. They were really trying to push me to get the procedure done. When I got that initial call it was such a shock that I really didn’t know if I wanted to get the procedure. It probably took me about a week to fully understand what was going on.”

Boyle and Lally had both been diagnosed with the same condition. There was an extra electrical pathway in their heart: Wolff-Parkinson-White syndrome. “They said my heart was going too quick,” says Lally. “The bottom two ventricles were contracting too quickly. Not enough blood was getting around my body.”

“I was straight on to Google,” says Boyle, “trying to see what it was.”

The success rate for the procedure is extremely high. The issue is detection. The risk is in carrying on, not knowing. For elite athletes, the potential trigger is strenuous exercise. Was there a chance that nothing would happen if nothing was done? There was no future in that train of thought.

Boyle sought a second opinion in the Northern Ireland Health Service. The original diagnosis was confirmed. On February 22nd he had an appointment with Dr Jonathan Lyne, a cardiologist in the Blackrock Clinic in Dublin.

“It was more than a month after the screening and it still didn’t feel like there was anything wrong with me,” says Boyle. “I had seen a couple of specialists up here and they said, ‘You can’t play. Don’t do anything until you see Dr Lyne.’ Me and my da went down and he painted it a bit more serious.

“‘Yes, you can probably live with this in your life but you’ll no longer be able to play sport if you don’t have the procedure.’ In my case, it wasn’t a case of ‘if’ an episode would happen, but ‘when’. It could be a cardiac episode of any sort – something small or a heart attack or a stroke. More or less, it will happen at some point [without the procedure]. He said he couldn’t believe that I didn’t have dizzy spells or I hadn’t passed out.”

Boyle had no symptoms; Lally didn’t recognise them. Before Christmas she couldn’t catch her breath in a training match. Her breathing was so laboured that the player she was marking advised her to step out. She didn’t think any more about it. As long as Lally had been playing football she had dealt with breathlessness.

“I presumed it was a lack of fitness,” says Lally. “You’d kind of just presume you’d know if you had a heart condition. But I’ve never been able to get fit. This is my sixth year on the Mayo senior team and I’d never say that I felt fit, even though we were doing so much training. I could never get my head around doing the same level of training as everybody else and never getting to the next level of fitness.

“When they were asking me about my symptoms before the procedure I said ‘no’ to everything because I just presumed being breathless was just me being unfit. I never thought it would be related to the heart. Everything growing up makes sense now – how I was out of breath so easily at training for the 16 years that I’ve played.”

Cardiac screening has been on the GPA’s agenda for years. The outreach and the up-take has been building. In 2020, 284 male players were screened; two years later that number had swollen to 520, male and female; last year the figure was 737.

From a total membership of about 4,000, though, those numbers still leave an uncomfortable discrepancy. An invitation is extended to every intercounty panel, at the GPA’s expense. Not all of them take it up. An ECG takes about 20 minutes. If 30 players agree to be screened you can do the maths on how long it will take. Do they have better things to do with their time? The obvious answer has not landed with every intercounty manager yet.

Building awareness is the challenge. Earlier this year the representative bodies for soccer players, jockeys, rugby players and the GPA came together to form Irish Athletes Alliance. Their first policy mission is to lobby the Government for cardiac screening for every elite athlete. In Italy cardiac screening has been mandatory for everyone involved in competitive sport for the last 25 years. The European Society of Cardiology recommends that everybody involved in competitive sport should be screened every two years.

The Dillon Quirke Foundation is on the same path. Established in memory of the young Tipperary hurler who died of Sudden Adult Death Syndrome (Sads) the foundation has been targeting young teens for early intervention. In Italy, the number of deaths from Sads has fallen by 89 per cent since screening was made compulsory. In Ireland, two people under 35 die from Sads every week. Prevention is the cure.

The corrective procedure involves burning off some nerves around the heart to regulate its electrical activity. Every date is logged in Boyle’s memory. On March 22nd he checked into the Blackrock Clinic for a procedure that evening. The following morning they realised they would have to perform the surgery again. On April 10th the news was better. All clear.

While he was waiting Boyle had stayed involved with the Antrim panel. On the side he did some light work on an exercise bike, hooked up to a heart monitor, or he fell into ball-striking drills if they were one player short for even numbers. Everything was non-contact and cotton-woolled.

After the operation he was on blood thinners for a fortnight, and the area of his groin where the surgeon had made an incision to reach his heart needed some time to heal. But there were no other restrictions. The bomb was no longer ticking.

When Antrim beat Wexford a fortnight ago he was part of the training panel; a day later he played for Loughgiel, his first match since the middle of January. In the first half he scored five points from play; in the second half he ran out of puff. Nothing serious.

“My mother was at the match,” says Boyle. “She was a wee bit worried about me going back, but there’s no other option. People outside of sport or who don’t play hurling don’t understand. If I don’t play hurling I don’t know what I’d do. I was probably being a bit selfish about the whole thing. I never realised the gravity of it.

“I think the person that probably appreciates it most is my mother. She was really worried. Did it cross my mind how lucky I was? Probably not. But my ma and da, yes, it crossed their minds. My ma even said it to me, I’ll probably not realise [how lucky I was] until five or 10 years down the line. All I was worried about was getting back playing.”

Lally is back playing too, the procedure done. They reckon she had the condition since birth. Never found, never checked, never crossed anyone’s mind. “You know,” she says, “this potentially could have saved my life – 100 per cent.”

Mayo play Galway in the Connacht final this weekend. Maybe not life and death.