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It was about three minutes into the second term of St Kilda's round four clash with Geelong when St Kilda defender Dylan Roberton started to feel dizzy.
Key points:
- Leading cardiologist predicts heart problems among athletes will become more common as the demands of professional sport intensify
- Athletes are at greater risk of heart issues due to the strain they place on their bodies
- Screening procedures used in professional sport means heart conditions are also more likely to be picked up in athletes than in the general public
Moments later, he blacked out and dramatically fell to the ground at the top of the goal square.
His collapse, away from the play and any opponents, was so inexplicable at the time that the St Kilda medical staff who ran onto Kardinia Park to treat their player heard a Geelong player deny that he had taken Roberton out.
The 27-year-old regained consciousness a few seconds later.
Tests would later show that irregular electrical activity in his heart had caused extra heart beats to occur.
Roberton is one of two AFL players, along with Carlton's Matthew Kreuzer, to have had his 2018 season cut short by heart problems.
Athletes' hearts 'under great strain'
One of Australia's leading cardiologists fears that heart complaints in athletes will become more common as the demands of professional sport grow.
"I fear that with higher levels of sporting excellence, that this may come at a cost — that cost being more athletes presenting with heart conditions," said Chris Semsarian, the head of the molecular cardiology program at the Centenary Institute.
Professor Semsarian said athletes were at higher risk of developing heart conditions because of their occupation.
"They're putting their heart under great strain during sports. That puts pressure on the heart," he said.
But he said heart problems were also more likely to be diagnosed among athletes than among the general public due to the advanced screening procedures used in professional sport.
Roberton has had a monitor surgically inserted to assess his condition, and has responded well to medication for a small area of inflammation in his heart.
He has also had a defibrillator implanted as a precautionary measure.
This device can shock the heart back into a regular rhythm and save the life of the owner if required.
St Kilda club doctor Tim Barbour said there were few warning signs for Roberton that a condition existed.
"He just reported some mild symptoms of dizziness leading up to it, very short-lived for a couple of seconds, and then doesn't recall anything after that," Dr Barbour said.
'We're not normal people'
Unlike Roberton, two-time world champion triathlete Emma Carney experienced six years of symptoms before a cardiac arrest forced her into retirement in 2004.
"I was feeling a tightening in my chest and an overwhelming tiredness … I put it down to maybe my training was wrong," she said.
"I had some blood tests, I thought maybe my bloods were out. I never ever thought that I was developing a serious heart condition," Carney said.
Carney had a defibrillator implanted but her prognosis meant that a return to elite competition was impossible.
"When I was finally diagnosed with right ventricular cardiomyopathy, I said to the doctor, 'Well okay, how do we fix that?' and he said, 'Well we, can't'," Carney said.
"And I said, 'Well, how can we fix it well enough, so I can keep racing?'
"You don't really accept it and to this day I probably haven't accepted that because I've been told, 'You can no longer do what you love doing'."
Professor Semsarian said Carney's response was not unusual.
He said the competitive nature of athletes meant persuading them to prioritise their health over sporting ambition was challenging.
"I am forever amazed at the way athletes will never give up," he said.
"You tell them that they have a major heart condition that could kill them and they say, 'What do I need to take so I can get back on the field?'"
Even now, Carney said if stem cell research was available to fix her heart issues, she'd sign up and go back to competitive racing.
"Why do athletes push themselves? We're not normal people. If you put us under a microscope and looked at our brains we are not normal, we try and push ourselves beyond reason," she said.
St Kilda's Dr Barbour said Roberton was "very level-headed" and was taking a measured approach to his return to football.
"[He] has got great family support around him and I think fairly quickly realised that there's a lot more to it than football," Dr Barbour said.
"We spend a lot of time educating players and their families regarding where things are at, regardless of the condition, the potential consequences, what we know and what we don't know. That takes a fair bit of time and consideration."
Dr Barbour said Roberton was now training "at very good levels" and would undergo his next round of tests in the next one to two months.
Carlton has not disclosed the nature of Kreuzer's condition but expect him to do a full pre-season in 2019.
Both are expected to return to action next year.
Topics: sport, australian-football-league, heart-disease, diseases-and-disorders, health, triathlon, melbourne-3000, geelong-3220, vic
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