In the last few days, FIFA has been shocked and deeply distressed by the news of the sudden and premature death of three young players on football pitches. Antonio Puerta died as a result of a generally rare (1:1,000) weakness of the right ventricle, which is, however, a significant and common cause of sudden cardiac arrest among athletes. In such cases, an alteration of the cardiac muscle tissue leads to an expansion of the right ventricle, which can cause fatal changes in heartbeat and can ultimately lead to cardiac arrest.

Israel-based Zambian international Chaswe Nsofwa recently collapsed after a training session in the southern Israeli town of Beersheba and died shortly afterwards. The exact cause of his death is not yet known. Just over a week ago, Walsall's 16-year-old youth player Anton Reid also passed away after collapsing on the pitch.

Generally, the most common causes of sudden cardiac arrest can be identified in young athletes during thorough consultations that take family history into account and by conducting a physical examination that also focuses on the heart. In the build-up to the 2006 FIFA World Cup Germany™, concerns about player health and preventing such tragic incidents prompted the FIFA Sports Medical Committee to demand not only a general medical check-up but also thorough cardiovascular tests including electro- and echocardiograms from all teams.

"We know that thorough preventive examinations can reduce the risk of sudden cardiac arrest," said FIFA chief medical officer Professor Jiri Dvorak in March 2006 at FIFA's team workshop in Düsseldorf as he presented a questionnaire and form for preventive examinations developed by the FIFA Medical Assessment and Research Centre (F-MARC) to the team doctors. Consequently, all players who participated in the 2006 FIFA World Cup Germany were required to pass through this thorough preventive programme with specific examinations. The depersonalised data was then analysed by specialists including a cardiologist.

FIFA's preventive measures have since been detailed in a report on the 2006 FIFA World Cup Germany in a scientific journal and praised by the publishers as an important signal from a major sporting organisation.

"As the attention of the whole world was going to be focused on the World Cup in Germany, we wanted to send out a clear signal that the footballers' well-being took pride of place," said Dvorak today. "Once we began to evaluate the data however, we became more and more convinced of the general need to make this preventive programme obligatory."

The programme, which has been expanded to cover issues specific to women, will also be the subject of debate at an international symposium that will be held to coincide with the FIFA Women's World Cup China 2007.

FIFA will be discussing this issue, as well as other medical matters such as doping, at the next meeting of the Executive Committee in Zurich on 30-31 October.