MILAN (AP) -An Italian sports medicine specialist has called for more government investment to prevent athlete deaths, a day after a former Italy under-21 footballer died after collapsing during a game.
Livorno midfielder Piermario Morosini died Saturday after suffering cardiac arrest on the pitch during his team's Serie B match at Pescara. He was 25.
"When such dramas happen, you are stunned," Pino Capua, the director of sporting medicine at the San Camillo di Roma hospital, told The Associated Press on Sunday. "This tragedy is something that's unthinkable, an event that was totally unexpected.
"I believe that the structures of sporting medicine have to be improved. The government has to invest in the health of athletes. Investing in the structures of sporting medicine would mean focusing on prevention, and that would be a considerable saving when compared to health spending. So many lives would be saved."
It was the latest high-profile case of a football player collapsing from heart failure on the pitch, coming less than a month after Bolton midfielder Fabrice Muamba suffered cardiac arrest during a game in England. Muamba survived, but remains in intensive care.
At the time, Italy, with its stringent checks on players, was held up as a model to follow.
"The reality is this sort of thing is likely to happen occasionally and rarely," Professor Peter Weissberg, medical director of the British Heart Foundation, told The Associated Press on Sunday. "In England, we don't have complete foolproof screening tests. I think if there were foolproof tests that identified everyone at risk, it would be better.
"My understanding is that in Italy, in particular, they are pretty fastidious about that. They make a pretty big noise about it. I would be amazed if this player hadn't have been screened so it just shows."
Morosini's death also comes days after AC Milan and Italy striker Antonio Cassano was given the all clear by a 10-man committee of experts to resume playing again following minor heart surgery after he fell ill with stroke-like symptoms on a flight after a game six months ago.
"In Italy sporting fitness tests are frequent and rigorous, the gaps between them are very narrow," Capua added. "The culture of medicine in sport is at a very high level but here we are faced with an unexpected event. At Pescara, the first aid was prompt, the doctors did everything they could have done, but unfortunately the boy didn't make it.
"Those who play sport at a professional level - apart from unthinkable events - are secure. My thoughts go to those who practice sport at an amateur level and at a youth level, because you can do a lot there. During the weekend millions of people undertake sporting activity but only a minimum part do it in the presence of a doctor. We lack the medical structures, almost half of young sportspeople go out onto the pitch without having done even the minimum cardiac exam."
The problem is not restricted to football. Less than a month ago, former volleyball Olympic silver medallist Vigor Bovolenta died after he was stricken with a heart attack while playing a game.
"They are different cases, with different problems," said professor Eugenio Martuscelli, a cardiologist at the Tor Vergata hospital in Rome. "For Morosini, we have to wait for the autopsy to understand well what was the real cause of death. Because the reasons could be different: cardiac, rupture of the aorta or a cerebral hemorrhage. In the latter two cases there would have been little to do and it would have also been difficult to identify potential problems beforehand to prevent it.
"The Italian system which certifies medical fitness for sport is the most strict and secure in the world for an athlete. Doctors have the power to stop the athlete if there is something which is not right. They can ask for the intervention of more Italian specialists in hospitals and in universities. And I can assure you this happens in hundreds of cases every year."
The reason for Morosini's death will become clearer following an autopsy as well as an investigation that will be opened Monday into the delay in the ambulance reaching the stricken player.
The delay was caused by a car belonging to traffic police that blocked the ambulance's way into the stadium. A window had to be broken so the car could be moved, while players and officials were frantically gesturing for the ambulance to get there as quickly as possible.
Martuscelli has called for improvements to be made in the quality of pitchside treatment available.
"We have to improve the on-the-pitch intervention," he added. "If you want to have the hope of saving a life it is necessary that in the space of a few minutes personnel specialized in cardiopulmonary resuscitation are able to intervene and know how to use a defibrillator that has to be present.
"It's clear that there are interventions that can help only if the problem is cardiological, but records tell us that in sportspeople, problems are often to do with the heart. It must become compulsory to have these people pitchside, it is the only further guarantee we can give the athlete."
There have been several deaths in top-level football over the past decade. Marc-Vivien Foe collapsed and died during Cameroon's Confederations Cup match against Colombia in 2003, while Sevilla's Antonio Puerta died in 2007, three days after collapsing with a heart attack during a league match against Getafe.
Motherwell midfielder Phil O'Donnell died in a similar incident and Espanyol's Dani Jarque also died of a heart attack in the team hotel on a pre-season trip to Italy.
FIFA will be studying cardiac arrest cases involving football players and the project will be put forward at FIFA's medical conference on May 23-24 in Budapest, Hungary.