As the World Cup kicks off, cardiologists are warning fans with pre-existing heart conditions that the emotional intensity of matches can put a serious strain on the cardiovascular system.
“Intense emotions, whether positive or negative, can act as ‘precipitating risk factors’ for cardiovascular events such as heart attack,” cardiologist and European Heart Network board member Paola Santalucia told Euronews Health.
Strong emotional excitement, like feeling fervent about your national team making it to the next round or a nail-bitingly intense penalty shootout, could be dangerous for people with pre-existing heart disease, Santalucia said.
Those affected by other risk factors such as hypertension, obesity or smoking should also exercise caution during emotionally charged matches, she added.
Strong emotional excitement can increase heart rate, blood pressure and stress hormones such as cortisol. In some cases the heart can race as fast as 150 beats per minute — a level comparable to sprinting.
That’s according to a recent wearable-based study that measured football fever — heart rates and stress levels — during the 2025 German Cup final and compared them with measurements taken on normal days over a 12-week period.
“The biggest impact is for fans that actually watch the game live in the stadium while drinking some beer,” said Christian Deutscher, a professor of sports economics at Bielefeld University in Germany and co-author of the study. He told Euronews Health that heat can put an additional strain.
Even those watching from home showed measurable physiological responses. “They still had an increase [in their] heart rate that compares to walking, even though they didn’t walk,” he said.
Deutscher highlighted that the most intense physiological reactions are not necessarily during goals alone, but 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,” Deutscher. He and his colleagues are currently collecting data from fans in a follow-up study during the ongoing World Cup.
Don’t blame football
Football itself is not the problem. Rather, it is the body’s response to intense emotions.
“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,” Dan Atar, cardiology professor at the Oslo University Hospital in Norway, told Euronews Health.
In “a few unlucky individuals” such a body reaction may trigger the rupture of an existing atherosclerotic plaque — a buildup on the artery walls, leading to a heart attack.
Atar underlined that this can happen anywhere, anytime. For example, in Norway, heart attacks happen when people shovel the snow early in the morning — a situation that also triggers adrenergic stimulation.
“It is in no way dangerous to watch a football game,” he reassured. “All this is physiologic. It’s not dangerous to be excited.”
However, Atar agreed that the combination of emotional stress, alcohol consumption, heat and underlying cardiovascular conditions can increase risk “that something untoward happens.”
To avoid ‘untoward’ situations Santalucia urged people at higher risk to continue taking their prescribed medications, avoid excessive alcohol, smoking and stimulant substances, and not ignore warning symptoms such as chest pain, shortness of breath or a very fast 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 said.