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ESC Congress 2003: Watch football and die?

August 31, 2003

IMPORTANT: This press release accompanies a poster or oral session given at the ESC Congress 2003. Written by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology

ESC Congress 2003: Our study shows an increase in out-of-hospital sudden cardiac deaths in the adult population of Switzerland during the 2002 FIFA World Cup in comparison to the same period in 2001. Based on this observation we suggest the reinforcement of pre-hospital cardiac care during major sporting tournaments as well as special counseling to patients and their families by their general practitioners before such events.

Psychological stress and anger are documented triggers of myocardial infarction. It has already been described in environmental disasters (Athens and Los Angeles earthquakes) or at the peak of the Iraqi missile attacks on Israel. Knowing that more than 80% of cardiac arrests in adults are linked to myocardial infarction, we wanted to test the hypothesis that mental stress and anger increase the rate of sudden cardiac death in adult populations. In Switzerland 2002 FIFA World Cup was a very successful sporting event watched by a major part of the Swiss adult population. According to FIFA data the total TV audience of the 2002 FIFA World Cup in Switzerland was close to 11 million (Main resident population of Switzerland - 7.2 million inhabitants). As psychological stress and anger are common for most viewers of soccer, we predicted an increase of out-of-hospital cardiac arrests during this competition.

In Switzerland, as in most European countries as well as in the USA, central registers of out-of-hospital sudden cardiac deaths are non-existent. However the MICU's (Mobile Intensive Care Units) qualified to carry out the emergency cardiac care are also very often called in to confirm deaths. MICU's registers of major cities of French and Italian speaking provinces of Switzerland were analyzed for the FIFA 2002 World Cup period and compared to the same period in 2001.

A significant, 60% increase of the out-of-hospital cardiac arrests was noted during FIFA 2002 World Cup. Among people having suffered cardiac arrest during FIFA, competition an increase in the proportion of males and deaths at home has also been found. Even if it is impossible to prove that all victims of out of hospital sudden cardiac deaths were soccer play viewers, the important increase of cardiac arrests during the football matches was observed and is unlikely to be only due to hazard. We interpret this by an increase in mental stress, alcohol and tobacco consumption and decreased medical observance and physical activity of football supporters.

These data need to be confirmed by other observations. Nevertheless, we can already advise general practitioners to inform their patients and their families before major sporting events about the risks of unhealthy behavior and medical non-observance. The media can provide more information to the general public about practical measures to adopt in case of cardiac symptoms, myocardial infarction or cardiac arrest (e.g "call first - call fast" campaign, "basic life support" campaign) and thereby increase the chances for successful resuscitation. The reinforcement of the emergency cardiac care systems (e.g. increased number of physicians and paramedics on call, changes in automated defibrillators deployment strategies, development of public access defibrillation programs) during major environmental events may also be proposed in order to reduce the burden of out-of-hospital cardiac arrests.

Dr Euge'ne Katz, Dr Jacques Metzger, Dr Juerg Schlaepfer,   Professor Martin Fromer, Professor Lukas Kappenberger
Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

European Society of Cardiology (ESC)




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