The death yesterday of a third footballer in the past ten days has focused attention on the care given to players by the game’s authorities, but while the screening of players in England has never been more comprehensive, a leading heart specialist has called for more effective cardiovascular testing.

Chaswe Nsofwa, a Zambian player with Hapoel Beersheva, of Israel, collapsed during training yesterday and died in hospital. Antonio Puerta, of Seville and Spain, died on Tuesday, three days after collapsing in a league game. Last week, Anton Reid, a 16-year-old Walsall trainee, died after a training session. Clive Clarke, of Leicester City, is recovering after collapsing at half-time during a Carling Cup tie away to Nottingham Forest on Tuesday.

Yesterday Dr Dorian Dugmore, the director of the adidas Wellness centre and a member of the European Society of Cardiology, advocated a more rigorous testing programme using electrocardiograms (ECG) to assess heart function during sporting activity.

According to Dugmore, existing screening is often inadequate because the ECG is taken while the athlete is at rest. “That doesn’t tell you what’s happening when a player is pushing himself to exhaustion,” he said. “People should be stress-tested to their maximum . . . they [the authorities] should seriously consider doing this with all players on a regular basis.”

New regulations relating to the emergency care of players at Barclays Premier League matches came into effect at the start of this season, with an ambulance at every game purely for the use of players and officials, along with two fully equipped paramedics. By next season club doctors and physiotherapists must have completed an advanced resuscitation and emergency aid course. Every Football League match must be attended by a registered medical practitioner and at least one paramedic.

The FA and Professional Footballers’ Association (PFA) fund a scheme, in its tenth year, that gives every 16-year-old at a professional club a comprehensive cardiological screening. “Our programme has picked up one or two instances each year, which can be a real disappointment to the player and the parents, but we feel duty-bound to say ‘You need to know this and then it is your decision,’ ” Gordon Taylor, the chief executive of the PFA, said.

Conditions that develop after that age may not be detected, while the large number of players entering the game from abroad will not have passed through the scheme and their medical records are sometimes not available.

“All Premiership footballers should have cardiac screening and it is in the Premier League rules for the first time this season,” Dr Nigel Sellars, Ports-mouth’s club doctor, said. “It sounds as if the lad at Walsall was unlucky, because we screen all our players at 16. Paul Hart, our new academy director, would like it to be 14. And then you think should it be 11, or should it be 9? I have heard that Puerta had not only been screened but had a full cardiological work-up so, if that is true, it’s even more scary that he died.

“As a club doctor, it makes you think about whether you are doing everything correctly at your own club.

Our players wear heart monitors for every training session and software puts the information straight on to a laptop so that every player’s heart record can be charted. The right things are happening – but it has been a freakish ten days.”

Taylor acknowledged that the increased demands of the modern game could be a factor. “I think because the game has become more competitive than ever, while there has been improvement in diet, physiology and training techniques, at the same time there can be pressures that reveal a weakness that wouldn’t be detected under less demanding circumstances.

“Marc-Vivien Foé [who died in 2003] was at the end of a long season and had played a number of games [in the Confederations Cup] and you wondered whether it was one game too many. So we have to keep monitoring 52 weeks of the year. We have made some progress, but it is incumbent on us to keep moving forward.”

José Manuel Reina, the Liverpool goalkeeper, was shocked by the news that Antonio Puerta, his Spain teammate, had died at the age of 22 after suffering a heart attack while playing for Seville against Getafe on Saturday. “It is so hard to take,” Reina said. “He was one of my teammates and all I can say is that my thoughts are with his family at such a bad moment. His girlfriend was pregnant and he was only 22. Apparently he was healthy, but these things don’t give you a call. It shows you have to enjoy life, thank God every day and live for each day.”

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