Spectators' Emotional Stress Linked To Heart Attacks

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Main Category: Cardiovascular / Cardiology
Also Included In: Anxiety / Stress;  Sports Medicine / Fitness
Article Date: 31 Jan 2008 - 9:00 PDT

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Researchers studying the cardiovascular effects of World Cup soccer matches on residents in Bavaria, Germany, found that the rate of heart attacks and other coronary events in men was three times higher, and in women was nearly two times higher, on days when Germany was playing, suggesting the emotional stress of watching their national team compete caused the events.

Media reports suggest many cardiologists would not be surprised if this was true of other big sporting events such as the annual Super Bowl in America, which this year takes place this Sunday, 3rd February 2008, in Arizona.

The study is published in the New England Journal of Medicine and is the work of researchers based at Ludwig-Maximilians University in Munich, Germany.

The German team came third in the 2006 World Cup, after losing to the eventual winners, the Italians, in the semi-finals.

For the study, the researchers counted incidence of coronary events in residents of the greater Munich area before, during, and after World Cup matches played by the German team, and compared them with those occurring during the same time periods in prior (non World Cup) years (2003 and 2005).

The types of coronary events they counted included: acute coronary syndromes, symptomatic arrhythmias, cardiac arrests, or therapeutic discharge of implantable cardioverter-defibrillators.

The researchers found that:

• Acute cardiovascular events were found in 4,279 patients.


• The incidence of coronary events during matches played by the German team was 2.66 times higher than the incidence during the control periods.


• This incidence rate was higher for men (3.26 times) than for women (1.82 times higher).


• In patients with a known history of coronary artery disease the number of events was 4 times higher.


• In patients without such a history, the risk was double.


• On days when the German team played, the highest average observed incidence of coronary events happened during the first 2 hours after the beginning of each match.


• There was no increase in coronary events for World Cup games not played by the German team.

The researchers concluded that:

"Viewing a stressful soccer match more than doubles the risk of an acute cardiovascular event."

They said preventive measures were urgently needed to tackle this large and excessive risk, particularly for men with an exisiting heart condition.

Writing in an accompanying Journal Watch article, Harlan M Krumholz commented that the study added to scientific knowledge about likely triggers of cardiovascular events and may help in preparing for increases linked to major emotional events.

Some doctors won't let their heart patients watch emotional matches.

In a news story in the Chicago Tribune earlier today, head of the cardiac intensive care unit at Advocate Lutheran General Hospital in Park Ridge, Dr Parag Patel, said that one of his patients had a heart attack straight after going to see Game 6 of the Cubs' playoff series with the Florida Marlins, in 2003. Apparently, later in that "fateful match", Chicago "blew a three-run lead".

Although his patient recovered from his heart attack, Patel wouldn't let him watch Game 7 while he was in the hospital. Patel told the Tribune, he just told his patient to "relax", commenting that:

"A lot of people felt heartbroken after that series, but he had the real deal."

It is unfortunate, as Krumholz wrote in his Journal Watch commentary, that:

"We do not have much information about how to prevent cardiovascular events triggered by emotion."

So perhaps that might be a fruitful area for scientists to investigate next.

"Cardiovascular Events during World Cup Soccer."
Wilbert-Lampen, Ute, Leistner, David, Greven, Sonja, Pohl, Tilmann, Sper, Sebastian, Volker, Christoph, Guthlin, Denise, Plasse, Andrea, Knez, Andreas, Kuchenhoff, Helmut, Steinbeck, Gerhard.
N Engl J Med 2008 358: 475-483.
Volume 358:475-483, January 31, 2008, Number 5.

Click here for Abstract.

Sources: NEJM abstract, journal watch, Chicago Tribune.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today