Nélson Puga on Casillas heart attack: “He could have played again” | OneFootball

At the third hearing of the trial, taking place at the Porto Labour Court, the sports medicine specialist said, in response to Casillas’s lawyer, that the former Spanish international had a low risk of suffering the problem again, as long as he followed his medication.

“On May 2, 2020, he could have returned to high-level competition. I do not have the slightest doubt about that,” he said.

Asked about the tests carried out on the player, he explained that no coronary disease was ever identified, even though Casillas showed only a slight increase in cholesterol, not enough to justify more specific heart exams.

In response to questions from Fidelidade’s lawyer, Nelson Puga refused to establish a causal link between training and the heart attack.

“The heart attack stems from the disease. Everything else is speculation. There are no scientific studies that allow us to say that training caused the heart attack,” he said, adding that Casillas had not made any unusual effort that morning.

The doctor also said that the player only later told him he had felt pain the day before, and he acknowledged before the judge that, in his view, the decision not to return to the pitch resulted from the player’s loss of motivation and both sides’ lack of interest in extending the contract.

Also heard this afternoon, cardiologist Luís Macedo, who treated Casillas after the heart attack, said that the speed of the intervention made it possible to limit the damage to the heart muscle.

“Time is heart muscle. The longer it takes to open the artery, the more lasting effects there may be,” he said, specifying that treatment took place about 90 minutes after the onset of symptoms.

According to the cardiologist, Casillas recovered his functional capacity, never showed arrhythmias in follow-up tests, and maintained preserved heart function.

“As far as I’m concerned, I think he could play,” he said, adding that it was Casillas himself who told him, after a year out, that he intended to retire.

In response to questions from the insurer, Luís Macedo said that if the player had sought medical assistance when pain appeared the day before — as described in CUF’s admission note, but denied in court by the former goalkeeper — the heart attack could have been avoided.

Asked by FC Porto’s lawyer whether there is scientific evidence establishing a causal link between physical exercise and heart attack, he answered no.

To the judge, he admitted that he could neither confirm nor rule out that training acted as a triggering factor in the episode.

Iker Casillas wants the acute myocardial infarction he suffered during an FC Porto training session in May 2019 to be recognized as a workplace accident.

In the lawsuit, he is claiming from insurer Fidelidade payment of 750,821.91 euros for temporary total incapacity and 1,521,780.82 euros for permanent total incapacity for his usual work (IPATH), as well as seeking an order for FC Porto to pay the portion of the compensation he considers not covered by the insurance, in addition to future medical and medication expenses and the redemption capital of the annual pension to be determined by the court.

At the previous hearing, the expert from the Medico-Legal Council argued that training may have acted as a triggering factor in the rupture of an atherosclerotic plaque, but considered that the primary cause of the heart attack was pre-existing coronary disease and that Casillas does not meet the conditions to return to top-level competition.

According to the newspaper Público, at the first hearing of the trial, held on June 8, Iker Casillas said that the heart attack brought his professional career to an end and left him with permanent limitations. “I can’t run, I can manage about 20 or 50 meters. No more than that,” he said in court at the time.

The trial continues on July 7.

This article was translated into English by Artificial Intelligence. You can read the original version in 🇵🇹 here.