Listen up sports fans: Any event that evokes a strong emotional response — such as excitement, stress or fear — has the potential to trigger a cardiac issue. So when you hear reports of a die-hard sports fan experiencing chest pain or even a heart attack when his favorite team loses a hotly contested match, it’s possible it was more than just a coincidence.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
With that said, the likelihood of dying as a direct result of a stressful sports moment remains quite low.
“Whether you have heart disease or not, the likelihood of sudden death from an emotionally stressful situation is quite uncommon in people who do not have pre-existing heart disease,” says Cleveland Clinic cardiac surgeon A. Marc Gillinov, MD. “It is difficult to predict who will be more likely to have such an event.”
Two of the most common cardiac events that can cause chest pain during stressful or emotional events are stress cardiomyopathy and heart attack.
Stress cardiomypopathy: Fight-or-flight
Stress cardiomyopathy is a condition in which intense emotional or physical stress can cause rapid and severe heart muscle weakness. The condition can be triggered by the adrenaline surge that occurs with a fight-or-flight response to a highly emotional situation.
Even people without an underlying heart problem can experience stress cardiomyopathy from emotional stressors such as grief, fear, extreme anger or surprise. Fortunately, in most cases, this condition is reversible, and the heart function returns to normal over time. In rare instances, it can cause sudden death.
Stress cardiomyopathy related to fear-evoking situations was first recorded in 1990 by Japanese physicians. While the phenomenon has remained somewhat elusive through the years, cases of stress cardiomyopathy have become more commonly diagnosed since an article about them appeared in the New England Journal of Medicine in 2005.
When the body is responding to a sudden stressful or dangerous situation, it pumps out a lot of extra adrenaline – or catecholamines. This surge in hormones causes immediate physiological changes that prepare the body for physical activity — the fight-or-flight response — meaning you are either going to run fast to get away or you are going to fight hard to defend yourself.
Some typical effects are increases in heart rate, blood pressure, blood glucose levels and a general reaction of the sympathetic nervous system that tells you whether to run or fight.
This affects the heart’s electrical system. This can cause arrhythmias, constriction of blood vessels (even when there aren’t blockages), or spasms that can cause the heart function to decline. In this instance, the heart muscle might stop squeezing and not pump blood as efficiently as it needs to.
Game-related heart attack grabs headlines
It’s also possible for a highly stressful situation to trigger a heart attack, especially in someone who already has risk factors. When a 69-year-old Brazilian soccer fan attending a hotly contested World Cup match between Brazil and Chile suffered a fatal heart attack earlier this year, the tragic event grabbed international headlines. It was later reported that the man suffered from hypertension and diabetes, both known cardiac risk factors.
While a German study published in 2008 in the New England Journal of Medicine found that a “stressful” soccer match increased the likelihood of a sudden cardiac event in male fans, the odds of it occurring are still quite low.