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Bodybuilder who collapsed after AFC celebrity fight died of natural causes: State Coroner

SINGAPORE — Bodybuilder and freelance gym instructor Pradip Subramanian, who collapsed after an Asia Fighting Championship (AFC) muay thai match in 2017, died from a heart attack stemming from two pre-existing and unknown heart conditions, a coroner’s inquiry has found.

Bodybuilder Pradip Subramanian collapsed after an Asia Fighting Championship muay thai match in 2017 against YouTube personality Steven Lim.

Bodybuilder Pradip Subramanian collapsed after an Asia Fighting Championship muay thai match in 2017 against YouTube personality Steven Lim.

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SINGAPORE — Bodybuilder and freelance gym instructor Pradip Subramanian, who collapsed after an Asia Fighting Championship (AFC) muay thai match in 2017, died from a heart attack stemming from two pre-existing and unknown heart conditions, a coroner’s inquiry has found.

There was adequate medical screening before the match and the on-site doctor would not have been able to detect Subramanian's condition without an electrocardiogram (ECG), State Coroner Kamala Ponnapalam said in her findings on Feb 11. 

The coroner said his cause of death was a cardiac arrest and respiratory failure, which was a “natural disease process”.

The 31-year-old bodybuilder was rushed to the Singapore General Hospital on Sept 23, 2017, following the match at the Marina Bay Sands Expo against YouTube personality Steven Lim.

He died close to 10pm that evening, two hours after the match began.

Subramanian was the president of the World Bodybuilding and Physique Sports Federation and was a last-minute stand-in for former Singapore Idol finalist and singer Sylvester Sim, who had been originally scheduled to fight Mr Lim.

The pathologist who conducted the autopsy on Subramanian found that he had an “enlarged and heavy heart”. 

The autopsy also detected that he had two hereditary heart diseases — cardiomegaly and cardiac channelopathy. Both can lead to various symptoms, including heart failure.

WOULD HAVE BEEN EXEMPTED FROM MATCH IF HEART CONDITION KNOWN

During the coroner’s inquiry, two representatives from national sports agency Sport Singapore (SportSG) recommended that those participating in sporting events involving high cardiovascular risk should undergo annual screening, including a resting ECG.

Event organisers can arrange this, or participants themselves could go for it, SportSG said.

On the day of the match, Subranamian was certified fit by the on-site doctor. He had also declared that he was free from any adverse medical condition.

Two independent medical experts from the Academy of Medicine of Singapore testified during the inquiry that the medical screening before the match had been adequate and timely.

One of them, Adjunct Associate Professor Tong Khim Leng, who used to head the cardiology department at Changi General Hospital, said that Subramanian would have been exempted from the match if he had been diagnosed with his heart conditions, as “exercise is known to trigger sudden cardiac arrest in such patients”.

The court previously heard that the match organiser was not compelled to require participants to conduct ECG tests.

Dr Benedict Tan, who chairs SportSG’s Sports Safety Committee, gave evidence that there is now a safety framework for sports events in Singapore, though its recommendations are not prescriptive. 

Privately organised sport events, such as the AFC match, are generally self-regulated, he said. 

Mr Alan Todd Vladich, director (National Sports Association) at SportSG, said that regulation may not be the most effective way of promoting safety practices, as injuries could still happen “given the vast spectrum of activities during any sporting event”.

State Coroner Kamala noted in her findings: “It was emphasised that adequate and appropriate training with a gradual build up in volume and intensity is essential for minimising the risk of sudden cardiac arrest. 

“(The SportSG representatives) also warned that being fit in one sport does not necessarily mean that the individual is fit for another sport. There must be self-awareness of one's fitness level and medical conditions.”

Related topics

muay thai Asia Fighting Championship Pradip Subramanian death Steven Lim

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