Doctors warn: With Chiefs in Super Bowl, KC fans are at greater risk of heart attack
In a decade of Kansas City Chiefs seasons, he can’t remember one when he didn’t treat at least a couple of fans who showed up at the emergency room in an ambulance, direct from Arrowhead Stadium.
They had heart attacks at the game.
“It has been stunning to observe how regularly I see this,” said Paramdeep Baweja, a leading cardiologist at Truman Medical Centers.
Watching a Chiefs game is literally too much for some people’s hearts to bear. Now with the team about to play in Super Bowl LIV, its most important game in 50 years, local cardiologists describe a perfect storm of circumstances that will put some fans at heightened risk of suffering a heart attack.
“That unfortunately is a possibility,” said Steve Owens, a cardiologist with the University of Kansas Health System. “The more emotionally wrapped up people are in cheering for the Chiefs, the more they’ll feel stress.”
The alcohol, the salty snacks about to be served up at watch parties all that anxiety from the passionate fans who have turned Arrowhead into a monster-loud house of football, combine to ratchet up the risk.
The people most likely to have a problem, according to science: Fans with known heart conditions, fans with unknown heart conditions and men.
Kickoff is set for 5:30 p.m. Sunday on Fox.
“This is a stressful thing Kansas Citians have coming up,” said James O’Keefe, preventative cardiologist with Saint Luke’s Mid America Heart Institute.
“Especially for such a big thing like a Super Bowl and we’re all so excited in Kansas City to have our team vying for the championship. Maybe it’s just because we’re in it, (but) it feels like there’s especially a lot of excitement around this game, both here in Kansas City and nationally, internationally.
“It’s not like you can say don’t take it so seriously. A lot of people are very emotionally attached to their team and take it personally.”
Some people, in fact, take their football so seriously they feel like they’re on the field themselves, which amps up the stress, Baweja said.
“As we are watching games like this, one of the things we experience is a sense of putting ourselves in the player’s shoes,” he said. “There’s a specific part of the brain that functions in this respect … where as we are watching the game, we feel like we are part of it.
“That’s when we talk about a game like this, we talk about ‘our’ team. We never say ‘the Chiefs’. We say ‘we,’ ‘us,’ we are going to win. And that relationship … is what really drives our excitement toward the game, all our emotions that happen through the game and a feeling of elation or sadness depending on the result.
“And I feel like for Kansas City this is a bigger stake now. We haven’t been in a Super Bowl for a long time. And the fans have been ardently waiting. The expectation is really, really high, as is excitement, because … we’re not sure we’ll make it here again next season so this is it.”
Watching sports can be bad for your heart
“There is clearly a correlation between stress and heart attacks,” said George Pierson, cardiologist with the Midwest Heart and Vascular Institute at Overland Park Regional Medical Center. “If the Chiefs haven’t given you a heart attack already, there are several things” that can while you’re watching the game.
The “sheer output of adrenaline that people can have in an excited state” is one cause, Pierson said. “Some people really get wound up about an event, and they can actually put out so much adrenaline that the arteries in their heart can spasm.
“It’s transient and people get over it. But they can still die from lethal dysrhythmias and need to be attended to.”
During the FIFA World Cup in the summer of 2006, emergency room physicians in the greater Munich area treated more than twice as many cardiac emergencies on days when the German team played than on non-game days.
Men experienced a higher rate of attacks than women, said the study, published in 2008 in The New England Journal of Medicine.
Another study in the Los Angeles area revealed a connection between heart attacks and the Super Bowl, Owens of KU said.
“It looked at the relative risk of cardiac events during the two weeks after the Super Bowl and they used 1980, the year that the L.A. Rams lost dramatically at the end of the game, and there was significantly increased risk of death and cardiac events for the next two weeks.
“As opposed to 1984, when the then-Los Angeles Raiders won kind of a boring Super Bowl game and there was really no blip in … cardiac events. Then they compared it to a year when an L.A. team wasn’t in the Super Bowl, and again there was no change in event rate.
“So having your hometown team in the Super Bowl would seem to increase your risk, which is understandable. But I would also observe that if your team is losing, the risk is even greater.
“So as loyal Chiefs fans, I would have to predict the risk is going to be greater for the San Francisco people than it is for those of us in the Kingdom.”
Fight or flight
Here’s what’s happening to your body as you’re watching Patrick Mahomes do his thing.
“As we experience the emotions, the body reacts in a very physical manner, too,” said Baweja.
“If there was a way to study how they move, how they react, how their muscles tense up, especially people who play the game themselves or have a deep interest in the game and know the techniques, know what plays would be next … you’ll see them actually tense up and posture almost in a way like they were the player.”
When you get excited your body starts releasing a flood of different chemicals, adrenaline among them.
“When you get all shook up about this, your adrenaline levels go up, your stress hormones, cortisol, go up,” said O’Keefe. “What these things are meant to do is prepare us to fight or flee, as if we’re out there playing with the Chiefs. So your heart rate’s up, your blood pressure’s up.”
Being in that fight or flight mode is a high-stress, ready-to-act mode, Baweja said. You start to feel flushed, you might get sweaty or feel fullness in your chest. Some people might feel nauseous, he said.
“For most young people, if they are young and healthy and don’t have active medical issues, this is something they can bear,” said Baweja. “This is almost like an intense workout for them. Many people will elevate their heart rate to the level of being on a treadmill for 10, 20 minutes and having gone through something of an intense exercise. For healthy people, that’s just fine.”
But for people who have medical issues already — high blood pressure, known or unknown heart problems such as a blockage in an artery, “one of these fluctuations in heart rate and blood pressure can be really stressful and can actually trigger a heart attack or trigger a stroke.”
When that fight-or-flight feeling kicks in, move, said O’Keefe.
“Stand up. Walk around after the game. Before the game go for a walk, jog. Lift weights. Just anything. Move,” O’Keefe said. “Those chemicals are meant to prepare you to move, and when you do move, exercise kind of burns off the stress hormones.”
Signs of distress
Stress can cause your heart to beat irregularly, a condition called arrhythmia.
“That would be the sense of our heart beating fast, or irregularly, and even if you’ve gone to a quiet place to try to get it to calm down and it’s not calming down, you need to be honest with yourself and recognize, ‘Hey, I think there really might be something wrong here,’ and get some help,” said Owens.
“Similarly, we all get a little tight in the chest when the action is intense, but if that tightness progresses and gets worse when it’s timeout or halftime and you’re still feeling bad again, recognize” something is wrong.
“Most people have a strong sense of denial about their heart. It’s amazing how people will come up with excuses for it not to be something serious.
“But be honest. If you’re having something that’s bothering you, don’t be afraid to tell somebody and get some help. It is amazing how many people wait until after the game to get attention for something. That does happen.”
Most people don’t describe the symptoms of a heart attack as pain “until it gets very bad,” said Pierson.
“What we worry about is somebody who begins to feel short of breath, they begin to break out in a sweat … they get sweaty, clammy, and then they just have a constant pressure in their chest, an unrelenting pressure,” said Pierson. “They say it’s like someone pushing on their chest. Some people describe it as an elephant sitting on their chest.”
Some people might simply chalk it up to indigestion.
“Then they begin to have more and more shortness of breath. Sometimes they’ll feel their heart beat irregularly, or they will actually collapse, and then, of course, they’re in dire distress if that should happen,” Pierson said.
“Men are notorious for toughing it out and not mentioning anything to their loved ones, or wife or significant other. So if you feel bad, tell somebody about it. And if symptoms persist, come in and check it out.
“Females tend to be better at taking care of themselves and asking for help if they’re in trouble. If nothing else, tell a loving female in the vicinity about it and she’ll make sure you get help.”
Cutting the risk
“You don’t want to be some sort of Debbie Downer doctor,” said Owens. “Everybody’s going to party.”
But maybe keep it moving at that watch party. “Get up and walk around during the time outs.. Don’t just plant in front of the food,” Owens said.
It doesn’t help that sports fans kick their regular diets to the curb on Super Bowl Sunday, cardiologists say.
All … those … chips.
The Super Bowl is the biggest day of the year for salty snacks, according to Frito-Lay, which estimates that nearly 8 in 10 Americans this year expect to find chips and pretzels at their Super Bowl event.
“Everybody is going to sit down with chips; they’re going to have barbecue,” said Pierson. “In my career I’ve seen several times people go out to their local barbecue joints, get a lot of sodium, and if they’re at all compromised, I’ve had certain people end up on ventilators.
“The sodium puts so much fluid into their systems that they actually go into what’s called pulmonary edema, where their lungs swell up and they have to be put on a ventilator while we get the fluid out.
“The sodium can also cause high blood pressure. So you have the adrenaline from the excitement, you have the sodium coming in and you can have high blood pressure, which can lead to a stroke. And we know that those events can happen around the course of a stressful event when people really get wound up, and some of the fans get really get wound up.”
And all … that … beer.
It’s people “who are not alcoholics … that have a couple of extra drinks, maybe four or five drinks during the course of the day, they are more at risk of having cardiac disrythmias,” irregular heartbeats, Pierson said.
Sports fans, like the players, need to stay hydrated. “Alternate a beer with a glass of water,” said Owens.
Owens and his fellow cardiologists say that doing some pregame homework — like the players — could go a long way to keeping stress at bay.
“You need to prepare for the game and take a little care of yourself. This is a stressful thing Kansas Citians have coming up, but it’s also super exciting and fun. Just try to enjoy the moment without putting too much stress on your heart,” said O’Keefe.
Do a mental check. Keep in mind that the game is supposed to be fun, said Baweja. “Again, this is what we deal with when we have an excited set of fans, such as in Kansas City right now, when we are in a moment of history to create something big.”
“It’s not worth jeopardizing your health over. In the long scheme of things, your health, your life trumps everything else.”
Owens said he has a neighbor who, when the games get too close, just leaves the room — a good idea if you can’t handle what’s happening. “Don’t be afraid to go off to a quiet space and find out from your friends later what happened,” he said.
Owens also suggested to have a game plan in mind just in case — dare we say it, did we just jinx it? — Kansas City loses.
“How are you going to cope with that?” said Owens, who admits he will be just as nervous as the rest of the city. “Are you going to get all worked up, stressed out, do dumb stuff? Just think about ‘what am I going to do?’ That’s sort of a bummer to think about.”
When Pierson used to work across the street from a casino, most of the heart attack patients who arrived from there had won money.
“Everybody expects to lose, but nobody expects to win,” he said. “So they’d get so agitated and excited that they’d have a heart attack after winning $100,000.”
On Sunday, “if the score is close and we’re looking like we’re going to win, I think we’re going to see more (heart) problems,” Pierson said.
“We certainly want us to win, but I think it’s going to be problematic as people celebrate afterward and continue to neglect their health after they celebrate.”
And he’ll be waiting. He’s on call on Sunday.
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