On June 12, 2021, Danish national soccer player Christian Eriksen collapsed on the pitch during the Denmark vs. Finland match at the 2020 European Championship shortly before the end of the first half. Sudden cardiac death is the name given to the phenomenon when the heart stops from one moment to the next. According to the German Heart Foundation, an estimated 66,000 people die of sudden cardiac death in Germany every year. Men are most frequently affected.
The German public broadcaster ZDF has now taken up the subject in a documentary that aired on June 18, entitled "The risk of cardiac death in professional sports - tragedy on the pitch." In the film, author Albert Knechtel lets various players have their say who have themselves already experienced sudden cardiac death but fortunately survived. Among others, the former professional soccer player of the Stuttgarter Kickers, Daniel Engelbrecht, is portrayed, who suffered a cardiac arrest three times during his active career. Later, doctors diagnosed him with myocarditis and a chronic cardiac arrhythmia. He underwent a total of six heart surgeries because of it. Although he returned to the court with a defibrillator, he had to end his career prematurely due to persistent heart problems.
Engelbrecht is a patient of Prof. Dr. Martin Halle, head of the Chair of Preventive and Rehabilitative Sports Medicine, who is interviewed as an expert in the ZDF film. During EURO 2020, he was on duty at the venue in Munich as "Chief Medical Officer" (CMO) for UEFA. The CMO is UEFA's medical representative and coordinates all medical issues on a match day.
The sports physician was immediately informed about the Eriksen case: "We doctors were networked with all the locations. I heard immediately that there was an event in Copenhagen and Eriksen had suffered a sudden cardiac death."
But how is sudden cardiac death triggered in the first place? Prof. Halle explains in the ZDF documentary: "The heart has an electrical system. And if this electrics gets mixed up and the heart has rhythm disturbances that are so fast and flutter so that the heart can't contract at all, with that the circulation is completely interrupted, not enough oxygen gets to the brain and then you fall over."
SARS-CoV-2 can also cause heart problems for athletes. Dr. Fritz Wimbauer, senior physician and head of the sports medicine clinic at Georg-Brauchle-Ring, therefore examined former professional soccer player Engelbrecht during the filming, who underwent a preventive examination in the aftermath of a COVID-19 illness. "In athletes, and especially young athletes, we know from studies that the risk of myocarditis is about one to three percent."
Prof. Halle also warns myocarditis following a corona infection may not even be recognized: "Coaches and players have always dealt with orthopedic injuries. Now something else is coming to the fore, namely a viral infection that also has a prolonged course and can then also affect the heart muscle. Perhaps not everyone has adjusted to this yet, but they have to. It is also not the case that myocarditis is always noticed immediately by oneself. But the lower leg muscle, you feel it."
Danish soccer player Christian Eriksen has since returned to playing with a defibrillator, making his comeback to English Premier League club FC Brentford in February 2022. A month later, he also returned to action for the Danish national team in a match against the Netherlands.
Prof. Halle is rather skeptical about such a comeback: "In my opinion, it is too high a risk for a competitive athlete to do competitive sports if a defibrillator like this is now fitted," warns the sports cardiologist. "With maximum stress, adrenaline to the limit, maximum physical and cardiovascular stress, there is of course the possibility that such an event will occur again, if it has already occurred once. It doesn't always have to be that way, that the defibrillator then works one hundred percent, and that would be a disaster, of course."
To the homepage of the Chair of Preventive and Rehabilitative Sports Medicine
Contact:
Prof. Dr. Martin Halle
Chair of Preventive and Rehabilitative Sports Medicine
Georg-Brauchle-Ring 56 (Campus C)
80992 München
phone: 089 289 24441
e-mail: sportmed(at)mri.tum.de
Dr. Fritz Wimbauer
Chair of Preventive and Rehabilitative Sports Medicine
Georg-Brauchle-Ring 56 (Campus C)
80992 München
phone: 089 289 24441
e-mail: fritz.wimbauer(at)mri.tum.de
Text: Romy Schwaiger
Photos: ZDF