Black African Footballers Have Unique Heart Adaptations Often Mistaken for Disease – Black Stars Team Doctor

Black Stars team doctor, Dr. Prince Pambo has revealed that Black African athletes develop unique heart adaptations that are significantly different from those of their Caucasian counterparts, a finding that has influenced how doctors assess the health of African footballers around the world.

Speaking in an interview with broadcaster Kafui Dey, Dr. Pambo explained that his PhD research in sports cardiology focused on understanding how the hearts of Black African footballers respond to the demands of intense physical activity.

According to him, sports cardiology examines how exercise affects the heart and how the organ adapts to accommodate the stress associated with competitive sports.

“I used football to determine the effect of physical activity on the heart of Black African players and the cardiovascular adaptation,” he said.

Dr. Pambo disclosed that one of the major discoveries from his research was the significant difference in heart structure between Black African athletes and Caucasian athletes.

“Big, big, big difference,” he said when asked whether his findings produced any surprising conclusions.

He explained that while the walls of the left ventricle become thicker in all athletes due to regular physical activity, the thickening is much more pronounced in Black African athletes.

“For the Black African athlete, it gets much thicker compared to that of the Caucasians, and this thickness makes it look like a hypertrophic cardiomyopathy,” he stated.

Hypertrophic cardiomyopathy is a heart condition that can increase the risk of sudden cardiac arrest. Dr. Pambo noted that in the past, many African footballers were wrongly flagged during medical examinations when signing for foreign clubs because their hearts resembled those of patients suffering from the condition.

“In times past, when our players are signed by big clubs and they go and do medicals, they disqualify them and say, ‘You have a cardiomyopathy,’ because the left side of the heart is so thick and it looks just like cardiomyopathy,” he explained.

However, he stressed that the adaptation is usually healthy and not a sign of disease.

“It doesn’t give them any problems. It’s a healthy adaptation. It only means that the heart is contracting a lot more and pushing a lot more blood forcefully,” he said.

Dr. Pambo added that genetics also play a role in these adaptations and suggested that the phenomenon is even more pronounced among West African athletes due to the nature of sports commonly played in the region.

“It’s genetic, to be honest. And even in Africa, it’s more among West Africans than East Africans because of the kind of sports we do,” he noted.

The findings, combined with studies conducted in the United States and England, have contributed to the development of new criteria for interpreting electrocardiograms (ECGs) in Black African athletes.

“Now we’ve been able to come up with a new criteria for interpreting the ECGs of Black African athletes. So what used to be abnormal now will be described as the Black African athlete heart,” he said.

Dr. Pambo, whose research was sponsored by FIFA during his studies in Germany, said sports cardiology continues to evolve as researchers seek to balance athlete safety with opportunities to compete.

He explained that medical experts are increasingly moving away from automatically disqualifying athletes with certain heart conditions and are instead adopting a “shared decision-making” approach.

“We sit down and say, ‘These people we just wrote off that they can’t play, what are they going to do with their lives?’ Then we go into research to determine the actual probability of risk,” he said.

Under the approach, athletes, family members and medical professionals collectively assess the risks before deciding whether an athlete should continue competing.

Despite the progress, Dr. Pambo cautioned that implementing such practices in Africa remains challenging due to limitations in emergency medical infrastructure at sporting venues.

“First of all, you need to guarantee that there will be a fully equipped ambulance with a lot of doctors so that if there’s an arrest they’ll be able to intervene. I can’t assure that here,” he said.

He revealed that he is currently collaborating with colleagues in the United States on further research aimed at understanding how athletes previously disqualified because of heart-related concerns can be safely managed and supported.

“It’s a new thing we want to do,” he added.