Screening and diagnostic specialists Vital Imaging have tested the likes of Neil Warnock, Alan Pardew and Tony Pulis while Roy McFarland is amongst those managers booked in for appointments at their London clinic.

Using Electron Beam Technology, imported from the USA, scans can detect disease years before traditional methods.

Warnock was shown to have early signs of heart disease, but Stoke City's Director of Football John Rudge received a far more dramatic diagnosis.

Rudge, who started out in management nearly 20 years ago, was shown to have a dangerously high level of calcium deposits in his arteries.

Vital Imaging Managing Director Robert Wilson explains: "The thing that furs up your arteries is essentially calcium deposits, so we measure the level of calcium.

"If you score anything over 400 you are already deemed at risk of a coronary event and John Rudge had a score of over 1,500. It is lucky he came in to see us when he did as he was an extremely high risk."

Wilson points out that early detection of heart disease can lead to steps being taken to ensure the condition does not deteriorate further.

"It's always better to know than not to know," he says. "The ones who have early signs of heart disease can start changing their lifestyle or take the appropriate drugs to lead a full and active life.

"John Rudge is certainly pleased he knows because he can now do something positive about it." Gerard Houllier, Joe Kinnear, Graeme Souness and Dario Gradi have all faced heart surgery in recent years and Rudge may now be forced to follow suit.

"He'll now discuss the options with the medical team and then a decision is made as to the best course of action," adds Wilson. "With lifestyle changes and aggressive treatment, there's a strong chance of positive improvement."

Rudge is thankful the problem has been identified. "I am very pleased this information has been brought to my notice and that I had the test," he said. "Without the scan I would have been none the wiser."

Wilson believes all managers should be scanned as the intense pressure placed on them makes them prime candidates for heart problems.

"I guarantee that if we scanned all the Premiership managers, we'd find one with at least early to mid signs of heart disease. I'm absolutely certain of that."

The League Managers Association has taken steps to ensure its members receive regular health checks.

"We have a year's programme which creates a profile and 48 managers have gone through it," says LMA chief executive John Barnwell.

"We're concerned that the job is an intense one involving former athletes who previously had a very fit regime. They've then had a complete role-reversal where all they're doing is looking after everybody else except themselves and inevitably that will lead to some physical problems.

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