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Perceiving, reporting and managing an injury – perspectives from national team football players, coaches, and health professionals

Author : Dele Bolade Samson Babalola


ABSTRACT

Background

Injury perceptions and related risk-mitigating interventions are context-dependent. Despite this, most injury surveillance systems are not context-specific as they do not integrate end-users perspectives.

Purpose

To explore how Maltese national team football players, coaches, and health professionals perceive a football-related injury and how their context influences their perceptions and behaviours towards reporting and managing a football injury.

Methods

13 semi-structured interviews with Maltese female and male national team football players (n = 7), coaches (n = 3), and health professionals (n = 3) were conducted. Data were analysed using thematic analysis.

Results

Three themes were identified: (1) How do I perceive an injury? Consisted of various constructs of a sports injury, yet commonly defined based on performance limitations. (2) How do I deal with an injury? Encapsulated the process of managing the injury (3) What influences my perception, reporting and management of an injury? Comprised personal and contextual factors that influenced the perception and, consequently, the management of an injury.

Conclusion

Performance limitations should be used as part of future injury definitions in injury surveillance systems. Human interaction should be involved in all the processes of an injury surveillance framework, emphasising its active role to guide the injury management process.

Epidemiology of Injury and Illness in North American Professional Men’s Soccer: Comparing COVID-19 Lockdown With Previous Seasons

Author : Dele Bolade Samson Babalola

Background:

After COVID-19 lockdown, studies across Europe and Asia examined its effect on professional soccer injury rates and severity; however, COVID-19 lockdown influence on injuries in United States men’s professional soccer has not been evaluated.


Hypothesis:

Injury and illness rates during the 2020 season were higher than the previous 2 seasons.
Study Design:
Retrospective observational cohort study.
Level of Evidence:
Level 3.

Methods:

Medical staff from participating Major League Soccer (MLS) clubs entered injuries and athletic exposures during the study period into a league-wide electronic medical record system. Injury rate and severity were analyzed to examine differentials between the 2020 COVID season and historical controls.

Results:

The injury incidence rate per 1000 hours in 2020 was 10.8, ie, higher than 2018 (5.4) and 2019 (5.0) (P < 0.05). Training injury incidence rate increased in 2020 (8.9) compared with 2018 (2.5) and 2019 (2.6) (P < 0.05), whereas match injury incidence decreased in 2020 (18.3) compared with 2018 (24.0) and 2019 (22.7) (P < 0.05). Incidence rates of lower extremity muscle injuries (6.04), anterior cruciate ligament (ACL) injuries (0.17), and concussions (0.49) were also higher in 2020 compared with 2018 (2.5, 0.07, 0.27) and 2019 (2.36, 0.05, 0.22) (P < 0.05). More injured players in 2020 missed >90 days (17.7%) than in 2018 (10.2%) and 2019 (10.1%) (P < 0.05). Incidence of all non-COVID-19 illness was higher in 2020 (3.93) than 2018 (1.53) and 2019 (1.32) (P < 0.05).

Conclusions:

During 2020, there were significant increases in incidence rates of overall injuries, training injuries, lower extremity muscular injuries, ACL injuries, concussions, and non-COVID illness, along with a higher percentage of players missing >90 days compared with the 2 previous seasons.

Clinical Relevance:

These results may help clarify the effects of future MLS inseason work stoppages and periods of restricted training.

Epidemiology of injuries in professional football: a systematic review and meta-analysis
Author : Dele Bolade Samson Babalola

Objective

We performed a systematic review and meta-analysis of epidemiological data of injuries in professional male football.

Method

Forty-four studies have reported the incidence of injuries in football. Two reviewers independently extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology statement and Newcastle Ottawa Scale. Studies were combined in a pooled analysis using a Poisson random effects regression model.

Results

The overall incidence of injuries in professional male football players was 8.1 injuries/1000 hours of exposure. Match injury incidence (36 injuries/1000 hours of exposure) was almost 10 times higher than training injury incidence rate (3.7 injuries/1000 hours of exposure). Lower extremity injuries had the highest incidence rates (6.8 injuries/1000 hours of exposure). The most common types of injuries were muscle/tendon (4.6 injuries/1000 hours of exposure), which were frequently associated with traumatic incidents. Minor injuries (1–3 days of time loss) were the most common.
The incidence rate of injuries in the top 5 European professional leagues was not different to that of the professional leagues in other countries (6.8 vs 7.6 injuries/1000 hours of exposure, respectively).

Conclusions

Professional male football players have a substantial risk of sustaining injuries, especially during matches.

Analysis of more than 20,000 injuries in European professional football by using a citizen science-based approach: An opportunity for epidemiological research?
Author : Dele Bolade Samson Babalola

Abstract
Objectives

It has been claimed that analyses of large datasets from publicly accessible, open-collaborated (“citizen science-based”) online databases may provide additional insight into the epidemiology of injuries in professional football. However, this approach comes with major limitations, raising critical questions about the current trend of utilizing citizen science-based data. Therefore, we aimed to determine if citizen science-based health data from a popular online database on professional football players can be used for epidemiological research, i.e. in providing results comparable to other data sources used in previously published studies.


Design

Retrospective database analysis.


Methods


Transfermarkt.com (Transfermarkt; Hamburg; Germany) is a publicly accessible online database on various data of professional football players. All information provided in the section “injury history” of football players from the top five European leagues over a period of ten seasons (2009/10–2018/19) was analyzed. Frequency, characteristics, and incidence of injuries were reported according to seasons and countries, and results compared with three previously published databases (a scientific injury surveillance, a media-based study, and an insurance database).

Results


Overall, 21,598 injuries of 11,507 players were analyzed from the Transfermarkt.comdatabase. Incidence was 0.63 injuries per player-season (95% confidence interval 0.62 to 0.64) but significant differences between subgroups (countries, years) were found. In comparison to other databases, citizen science-based data was associated with lower injury incidences and higher proportions of severe injuries.

Conclusions

With few exceptions (e.g., severe injuries), the use of citizen science-based health data on professional football players cannot be recommended at present for epidemiological research.


Section snippets
Practical implications

* •
More than 20,000 injuries were retrieved from the database Transfermarkt.com, and the cumulative incidence (0.63 injuries per player-season) was substantially lower than in reports from other data sources (ranging from 1.5 to 2.5 injuries per player-season).

•
A descriptive comparison to other studies revealed incomplete reporting with data being biased toward severe injuries.

•
With very few exceptions, the use of health data from Transfermarkt.com cannot be recommended for epidemiological research.

•



Methods


Data from the publicly accessible online database Transfermarkt.com (Transfermarkt; Hamburg; Germany) of the top five male football leagues in Europe (Premier League, Serie A, LaLiga, Bundesliga, Ligue 1) over a period of ten seasons (from season 2009/10 to 2018/19) were analyzed, and results were compared with those from a large scientific injury surveillance project, a media-based study and an insurance database. To the extent possible, data reporting follows the STROBE-SIIS guidelines on


Results

According to Transfermarkt.com, a total of 11,507 individual professional football players (goalkeeper: 15.1%; defensive: 37.5%; midfield: 39.4%: offensive: 8%) completed 33,600 player-seasons. All players were male. The youngest player was born in 2002, the oldest in 1969.
Among 23,820 “injury history” entries in the Transfermarkt.com database, 21,562 were reports of injuries (Table 1). The remaining 2258 entries were illnesses (e.g., flue) and other than medical reasons (e.g., fitness).
The

Discussion


This study is the first comprehensive scientific analysis of injury data from Transfermarkt.com.

The overall injury cumulative incidence of 0.63 injuries per player-season was substantially lower than in reports using other data collecting methods (ranging from 1.5 to 2.5 injuries per player-season).3,21,22 Notably, cumulative injury incidence varied between countries and years, emphasizing the need for careful assessment. Overall, many aspects did not correspond with previously published

Conclusion

The use of medical data from Transfermarkt.com cannot be recommended for epidemiological research with very few exceptions. At present, citizen science-based data is not suitable for accurate estimations of incidence and return to sports of non-severe injuries. Data of selected severe injuries (e.g., anterior cruciate ligament rupture) may be used if there is an implicit argument in its favor.

UEFA Champions League revenues, performance and participation 2003-04 to 2016-17
Author : Dele Bolade Samson Babalola

The UEFA Champions League revenues continue to grow (€ 1.3 bn in 2016-17), although previous studies have highlighted a competitive imbalance in the competition, and in the leagues supplying teams.

UEFA plans to increase the allocation of automatic qualifying places to 16 for the top four ranked leagues for 2018-19, and alter the financial distribution model.

This paper analyses the representation, performance and revenue distribution by club and UEFA member associations from 2003-04 to 2016-17 with reference to the quota changes and future direction.

UEFAs priorities are split, between meeting their core principles of governing 55 member nations, and commercial expectations from leading clubs. The findings demonstrate that the current structure offers clubs from England, Germany, Italy and Spain the most representation, revenue, and their clubs have the strongest performance.

The financial benefits of this enhanced access are vast. These clubs received€ 6.61 bn (61%) of all revenue, with sixteen clubs receiving€ 5.6 bn (52%) overall. The market pool element of the distribution model is where the most differences lie, calculated by UEFA.

Discussions include the benefits and issues with the quota changes around representation, revenue and performance, with reference to UEFAs aim to offer" fair competition" and" fair distribution" in the future.

Facilitators and barriers associated with youth player transition to professional first-team football: A key stakeholder perspective

Author : Dele Bolade Samson Babalola
Sports Science & Coaching 19 (3), 988-998, 2024

The transition of elite youth footballers through academy systems towards the first team is highly complex, competitive, and often unsuccessful. A myriad of factors including technical competence, physical prowess, and the development environment combine to determine youth player progression.

Current research has focused on broad investigations of multiple clubs and stakeholders, providing a valuable overview of the key aspects associated with elite youth player transition. This study aimed to provide an in-depth, context-specific investigation of key stakeholders within an elite level club in the United Kingdom (UK). Seven key stakeholders including the head of the academy (n = 1), the head of sports science (n = 1), coaches (n = 3), and lead sports scientists (n = 2) were recruited. Framework analysis led to the development of a practical framework outlining the key facilitators and barriers of youth-to-first-team transition.

Facilitators of transition included overcoming adversity, high-level physical prowess, exceptional technical competence, and possessing at least one elite-level attribute. Barriers to transition included a lack of opportunity, lucrative youth player contracts and a lack of development-specific coaching.

In addition, the developmental environment and developing individuals within a team environment were key influences on youth-to-first-team transition. This study complements recent broad investigations of the UK and global stakeholders by corroborating many of their findings while providing transferable, context-specific accounts of applied issues related to successful transition to first-team football.

Commercial determinants of health in sport. The example of the English Premier League
Author : Dele Bolade Samson Babalola

Transnational alcohol, food, beverage and gambling industries market their unhealthy brands to sport’s global audiences. However, there has been little research on the commercial determinants of health in sport and the world’s most popular sport and competition - football’s English Premier League (EPL).
Methods

I conducted four inter-linked studies to assess the commercial determinants of health in a case study of the EPL: 1) An internet scoping study of the sponsorship deals of EPL clubs in the 2018/19 and 2019/20 football seasons. 2) A content analysis of visual references to unhealthy brands during five EPL matches broadcast on subscription television in 2019.

3) The marketing strategies used by four EPL sponsors drawn from the gambling, food, beverage and alcohol industries. 4) A qualitative study capturing the stakeholders’ views about unhealthy brand sponsorship in football.
Findings

The EPL and its member clubs have multiple partners drawn from the unhealthy commodity industries. Gambling brands are most prominent both in club sponsorships and during ‘live’ football programmes. The brands appear both on players’ shirts and in pitch perimeter advertising. Sophisticated marketing strategies then activate traditional and digital methods to engage fans as consumers.

Stakeholders’ views on sponsorship reflect their level of economic and cultural capital.
Discussion and Conclusions

This study has described the marketing practices of unhealthy commodity industries in the EPL. Given that it has been demonstrated by others that this marketing is likely to damage the health of football’s global audience of fanconsumers, a more ethical approach to sport sponsorship deserves consideration.

Top 5 European football leagues–The association between financial performance and sporting success
Author: Dele Bolade Samson Babalola

Objectives of the study

The research consists of two primary objectives. First one is to provide an extensive theory basis of European club football in the field of sports economics.

The second objective is to further study the connection between financial performance and sporting success in European club football. The study especially seeks answers if financially successful clubs do well also in the field and vice versa. Motivational factor behind the study is UEFA’s Financial Fair Play Regulations, and the study aims to reveal their impact on the connection between clubs’ financial and sporting performance.

Data and methodology The sample consists of 690 observations of 139 different clubs that have played in top-five leagues (English Premier League, German Bundesliga, French Ligue 1, Italian Serie A and Spanish La Liga) between years 2008 and 2016. Financial data consists of revenues and operating profit, and it’s restricted through public availability.

Sporting success is measured by domestic league positions. Various multivariate linear regression models are built to study the correlation between financial and sporting performance. In addition, correlation results are analysed through various sensitivity tests, such as comparisons pre- and post- UEFA Financial Fair Play Regulations. Results The study offers lots of significant results of which one of the most important is that domestic league winners generate on average $59.2 million greater revenues and $13.5 million greater operating profit than other clubs. In addition, reaching one position higher on the league table rewards the club with $1.3 million greater revenues on average. Positive correlation between league position and operating profit is found only in German Bundesliga, where reaching one position higher on the league table rewards club on average with $1.2 million greater operating profit. Interestingly negative correlation is found in Italian Serie A, where cost of reaching higher on the table is on average $0.6 million reduction in operating profit. Almost same negative connection ($0.5 million) is found for whole data set before UEFA Financial Fair Play Regulations were introduced, but after the introduction no statistically significant connection can be found.
Hence, it could be argued that UEFA’s regulations have already had a positive impact on operational profit of the most sportingly successful clubs in Europe.

Intra-seasonal variation of injury patterns among German Bundesliga soccer players
Author: Dele Bolade Samson Babalola

OBJECTIVE:

High fluctuations in injury-risk during the playing season in soccer have been reported. As seasons are structured in periods with homogenous loads and intensities, we investigated injury-risk over season periods, contrarily to previous studies adopting a month-based approach.

DESIGN:

Cohort study; Level of evidence, 2.


METHODS:

Incidence-rate ratios (IRRs) for match and training injuries were compared across six consecutive seasons of German Bundesliga, divided into six periods each: Pre-season (PS), winter-break (WB), quarter 1-4Q1-Q4).
RESULTS: Significant variations in injury-risk were observed for match and training injuries. IRRs in matches was 1.30 (95% CI: 1.11-1.53) times higher in Q3 and 1.53 (95% CI: 1.31-1.78) higher in Q4 compared to Q1. For training injuries, IRR peaked in Q1 and Q3 followed by a marked decrease in each subsequent quarter. Compared to Q4, IRR was 1.62 (95% CI: 1.40-1.86) times higher during Q3 and 1.78 (95% CI: 1.53-2.07) times higher in Q1. IRR was significantly higher in the competitive season compared to pre-season across match (IRR: 2.00, 95% CI: 1.30-3.00) and training (IRR: 1.27, 95% CI: 1.11-1.43) injuries.

CONCLUSIONS:

The increased match IRRs later during the season indicate that, in practice, coaches should consider putting even more emphasis on recovery in the last part of the season.

Moreover, training injuries seem to indicate a carry-over effect. Further studies need to investigate how training during preparatory phases can be implemented in a way that prevents injuries during the competitive season.

Head injuries in professional football (soccer): Results of video analysis verified by an accident insurance registry
Author: Dele Bolade Samson Babalola

Background

Video analysis is one of the most commonly applied methods for analysing football injuries.

Purpose

The objective of this study was to assess the accuracy of video analysis for recording head injuries in professional football from official matches in the four highest men’s professional football leagues in Germany.

Methods

In this cohort study, head injuries detected by means of video analysis of all official matches over one season (2017–18) were compared to head injuries registered with the German statutory accident insurance.

Results

Our video analysis yielded 359 head injuries of 287 players. The comparison of head injuries found in our video analysis to those registered with the accident insurance only yielded a match in 23.1% (n = 83), which presents a rather low verification rate. The verification rates varied between the leagues (7.0–30.8%). All injuries documented in the accident insurance registry were found in the video analysis (100%).
The types of head injury most often verified by the accident insurance registry (n = 83) were contusion (43.4%), bone fractures (19.3%) and skin lacerations (18.1%). Only 66 of the 359 head injuries (18.4%) resulted in absence from at least one training session and involved a mean time loss of 18.5 days (1–87 days).

Conclusion

The mismatch between the number of head injuries found in the video analysis and head injuries registered with the accident insurance is an important methodological issue in scientific
research.

The low verification rate seems to be due to the unclear correlation between injury severity and clinical consequences of head injuries detected by means of video analysis and the failure of football clubs to register minor head injuries with the accident insurance.

Risk factors for hamstring muscle injury in male elite football: medical expert experience and conclusions from 15 European Champions League clubs
Author : Dele Bolade Samson Babalola

Objectives

To describe the perceived importance of suggested hamstring injury risk factors according to chief medical officers (CMOs) of European male professional football clubs.

A secondary objective was to compare if these perceptions differed between teams with a lower-than-average hamstring injury burden and teams with a higher than average hamstring injury burden.

Methods

First, CMOs of 15 European professional male football clubs were asked to suggest risk factors for hamstring injury in their club. The perceived importance of the suggested risk factors was then rated by all participants on a 5-graded Likert scale. Participating teams were divided in two groups depending on their hamstring injury burden during the 2019/2020 and 2020/2021 seasons.

The LOW group consisted of seven teams that had a lower than average hamstring injury burden. The HIGH group consisted of eight teams that had a higher-than-average hamstring injury burden.

Results

Twenty-one risk factors were suggested. The majority were extrinsic in nature, associated with coaching staff, team or club rather than players themselves. ‘Lack of communication between medical staff and coaching staff’ had the highest average importance (weighted average=3.7) followed by ‘Lack of regular exposure to high-speed football during training sessions’ (weighted average=3.6). The HIGH group perceived the player factors fatigue and wellness as more important than the LOW group.

Conclusion

According to CMOs recruited in this study, most risk factors for hamstring injuries are extrinsic and associated with the club and coaching staff, and not the players themselves.

Analysis of injury patterns in men’s football between the English league and the Spanish league:

Author : Dele Bolade Samson Babalola

Background

Injuries in professional football lead to reduced team performance and large financial losses. The aim of this study was to analyse injuries in the two best team competitions in the world (LaLiga and Premier League), establishing similarities and differences, as well as determining injury causation patterns.

Methods

A total of 277 on-field injuries requiring a substitution were analysed (142 in the Spanish league and 135 in the English league). The analysis was performed using traditional statistical tests (frequency analysis, chi-square test) with SPSS 25 and a T-Patterns sequence analysis with THEME 5.0.

Results

In the Spanish league, there were a similar number of injuries in the first part of the season as in the second part of the season, while in the English league, they are more frequent in the first part of the season. In the Spanish league, injuries are more frequent in the first half of the match, while in the English league, they are more frequent in the second half. The type of player most frequently injured was the defender. Most of the injuries occurred without the presence of an opponent. The accumulated minutes during the season affect injuries of the muscular type.

Conclusions

The most common type of injury in both leagues was a strain, followed by a sprain and a contusion. Although common injury patterns can be established between the two leagues, there are notable differences. One of the factors is determined by the English league calendar (many matches at Christmas).
In Spain, there were more muscular injuries that were not caused by the opponent, while in England there were more tackling injuries.
Age is a risk factor in the Spanish league. In this league, there is a moderately significant relationship between the number of injuries and the points won.

A systematic review of potential candidates of herbal medicine in treatment of chronic kidney disease
Author : Dele Bolade Samson Babalola


Background

Due to the toxicity issues of synthetic compounds, herbal medicines are preferred in treating or curing many diseases in recent times. Because of limited treatment options for chronic kidney disease (CKD), the use of traditional herbal medication to alleviate urogenital problems is the alternate therapeutic selection.
Purpose
Here, we summarized the research outcomes for the use of herbal medicine in the treatment of CKD and hurdles in the way for further research.

Methods

A relevant literature based on combinations of keywords such as herbal medicines, Chinese herbal medicine, CKD, chronic renal failure, nephroprotection, renoprotection, vegetable-based diet, and plant-based diets was searched using Pub med, Google Scholar, and Science Direct databases. The original articles published from 2006 to 2021 were taken into consideration. The literature was evaluated by studying the abstract or full text, all irrelevant studies were ignored.

Results

About 54 studies were found to describe the utilization of herbal drugs in the treatment of CKD in both human and laboratory animals, 17 studies described the clinical application of about 13 medicinal plants used against CKD in humans and 37 studies demonstrated the beneficial use of 24 medicinal plants in animal models and in vitro studies for CKD treatment explaining possible mechanisms of their action. The herbal treatment displayed anti-inflammatory, antioxidant, chemopreventive, and immune-mediated properties.
The anti-inflammatory action is well implicated via regulation of cyclooxygenase-2, signal transducer, and activation of transcription 3 and IκB kinase β pathways. These pathways are being hypothesized to produce convincing results in CKD. The CKD and gut microbiota is known to be closely related through inflammatory, renal, cardiovascular, and endocrine processes. The various concerns encountered during the use of herbal therapy in CKD are unpredictable pharmacokinetics, herbal and physiological interactions, electrolytic imbalance, and interaction with co-morbid conditions. The combined use of Chinese herbal medicine and Western medicine for the treatment of advanced-stage CKD was found to be effective in delaying dialysis initiation and reducing dialysis incidence.

Conclusions

A large number of medicinal plants have shown promising beneficial effects against several diseases including cancer, but only a handful of studies are available on CKD. Several studies explained the possible mechanisms of herbal medications in CKD for therapeutic use; however, the focussed molecular studies for identification of active components of medicinal herbs with their mechanism of action and safety standard are still awaited. The demand for well-designed clinical trials and rigorous pharmacological studies as well as a surge for combined use of herbal medicine and Western medicine for the treatment of CKD has been noticed. The nephrotoxicity issues of medicinal plants should not be ignored.

European soccer players: a matched cohort analysis of injuries from 2006 to 2016
Author: Dele Bolade Samson Babalola:

Background

Meniscal injuries are extremely common in soccer athletes, and little is known about postrecovery performance.

Purpose

To (1) identify characteristics associated with return to play (RTP) to the same league level and (2) evaluate long-term effects that injury and management approach may have on player performance.

Study Design

Cohort study; Level of evidence, 3.

Methods

Using publicly available records, we identified athletes who sustained meniscal tears across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2006 and 2016. Injured athletes were matched to controls 1:2 by demographics and performance. Investigations included rate of RTP to the same league level, reinjury, player characteristics associated with RTP within 2 seasons, long-term availability, field time, and performance metrics standardized to 90 minutes of play during the next 4 seasons.

Results

A total of 250 players sustaining meniscal tears were included, of which 106 (42%) received surgical management. Median absence was 57.5 days (interquartile range [IQR], 35-92) or 7 games (IQR, 4-12). Rate of RTP was 70%, and the reinjury rate 5% if a player could RTP. Age greater than 30 years was a negative predictor for RTP (odds ratio [OR], 0.62; P = .002), whereas higher preinjury goals per game (OR, 2.80; P = .04) and surgical management (OR, 1.38; P = .002) were positive predictors for RTP. Surgical management was associated with higher long-term availability (P < .01). As compared with the control, there were no significant differences in field time or performance metrics after RTP, either overall or by player position. As compared with nonoperative management, defenders undergoing surgery demonstrated decreased field time. Attackers and midfielders demonstrated similar field time and performance regardless of management.

Conclusion

RTP of elite soccer athletes sustaining meniscal tear is contingent on age, preinjury performance, and management approach. Those who RTP to the same league level can be expected to demonstrate equivalent field time, performance, and long-term availability as noninjured athletes.

Author: Dele Bolade Samson Babalola

Nigerian Journal of Cardiology 12 (2), 95, 2015

Background and objectives:

Despite reduction in door‑to‑balloon time in the management of acute myocardial infarction (AMI), prehospital delay by the patients has remained a major concern as benefits derivable from reperfusion treatments are time dependent.

This study aimed at evaluating knowledge and perception of warning signs of heart attack among civil servants in Ilorin, Nigeria.

Materials and Methods:

A pretested structured questionnaire was designed to obtain relevant information on knowledge and perception of heart attack symptoms; and action to be taken if one experiences the condition. Results: Questionnaires from 601 subjects consisting of 312 (51.9%) males and 289 (48.1%) females were analyzed. Although, 78% of the respondents have heard about heart attack, only 44.4% could discriminate a heart attack symptom from other conditions. Higher proportion of women (50.2%) than men (39.1%) could identify a core symptom of heart attack (P< 0.05).

Similarly, higher percentage of participants 40 years and older (48.3%) were more knowledgeable than those younger than 40 years (42.9%), but the difference was not statistically significant (P> 0.05). Higher percentage of women reported prior cardiovascular disease/risk factors than men.

Conclusion: We concluded that participants have low knowledge of heart attack symptoms with women being more knowledgeable than their male counterparts. There is the need for community education on heart attack warning signs and the need for early hospital presentation by affected individuals.

Authors
Dele Bolade Samson Babalola

Publisher
College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State University Teaching Hospital, Ado-Ekiti (EKSUTH) and Medical and Dental Consultant Association of Nigeria (EKSUTH Branch)
Description

Introduction

Acute myocardial infarction (AMI) is still regarded as uncommon in sub-Saharan Africa including Nigeria. Worse still, Physicians (especially non cardiologists) practising in this region might easily miss the diagnosis in young patient with atypical clinical presentation and without obvious conventional traditional risk factors such as hypertension and diabetes mellitus. We present a case of AMI in a young Nigerian male with atypical clinical presentation with the aim of drawing the attention of Clinicians to this rising medical emergency and also briefly review the clinical pattern of acute MI in young adults.
Case

A 29-year-old man who presented to our hospital with a 2-day history of epigastric pain associated with nausea, 7-hour history of retrosternal chest pain associated with easy fatiguability and diaphoresis.
Diagnosis

An antero-inferior acute ST segment elevation myocardial infarction (STEMI) due to atherosclerosis of all the 3 coronary vessels was diagnosed.

Conclusion
Acute MI is a life-threatening emergency and should be suspected in any individual with acute chest or epigastric pain presenting in the emergency setting irrespective of the age to ensure prompt diagnosis and treatment.
Abbreviations

MI= Myocardial infarction, ECG: Electrocardiogram, PCI= percutaneous coronary interventionKeywords: Myocardial infarction, Nigeria, young adult.