As the World Cup captivates audiences across Europe, cardiologists are urging fans with underlying heart conditions to temper their enthusiasm. The emotional rollercoaster of a penalty shootout or a last-minute goal can trigger physiological responses that, in vulnerable individuals, may lead to serious cardiovascular events.
“Intense emotions, whether positive or negative, can act as ‘precipitating risk factors’ for cardiovascular events such as heart attack,” explains Paola Santalucia, a cardiologist and board member of the European Heart Network. She warns that fervent support for a national team or the tension of a nail-biting match can be dangerous for those with pre-existing heart disease. Others with risk factors like hypertension, obesity, or smoking should also exercise caution.
Research shows that strong emotional excitement can spike heart rates to 150 beats per minute—comparable to sprinting—while elevating blood pressure and stress hormones like cortisol. A wearable-based study during the 2025 German Cup final, led by Christian Deutscher, a sports economics professor at Bielefeld University in Germany, found that fans in stadiums, especially those drinking beer, experienced the most significant physiological strain. Even home viewers saw heart rate increases akin to walking, despite being sedentary.
Uncertainty, Not Just Goals, Drives Risk
Deutscher notes that the most intense reactions occur during moments of uncertainty: penalty shootouts, VAR reviews, or shots hitting the post. “These uncertain moments are the ones we're striving for as fans, and we expect them to have the biggest impact on our vital stats,” he says. His team is currently collecting data during the ongoing World Cup to further explore these effects.
Dan Atar, a cardiology professor at Oslo University Hospital in Norway, emphasizes that football itself is not the culprit. “The adrenergic stimulation is at its max: extreme high blood pressure, high heart rate, and adrenaline, cortisol, skyrocketing—that is a known situation for an acute event,” he explains. In rare cases, this can rupture an existing atherosclerotic plaque, leading to a heart attack. Atar draws parallels to other triggers, such as shoveling snow in Norway, which also causes adrenergic surges.
“It is in no way dangerous to watch a football game,” Atar reassures. “All this is physiologic. It's not dangerous to be excited.” However, he agrees that the combination of emotional stress, alcohol, heat, and underlying conditions can increase the risk of adverse events.
To stay safe, Santalucia advises high-risk fans to continue their prescribed medications, avoid excessive alcohol, smoking, and stimulants, and not ignore warning signs like chest pain, shortness of breath, or irregular heartbeat. “The key message is not to avoid enjoying the match, but to do so with moderation and awareness, especially for those already at increased cardiovascular risk,” she says.
For a broader perspective on football's impact, see our interview with EU Sports Commissioner Glenn Micallef on politics and football ahead of the World Cup. Meanwhile, the financial side of the sport is explored in Why Investing in European Football Clubs Has Been a Losing Bet for Decades.
