Explaining cardiac arrest after Tom Lockyer collapse: How common is it in young footballers?

Luton Town captain Tom Lockyer suffered a cardiac arrest on the pitch during his side’s Premier League game against Bournemouth on Saturday.

Lockyer, 29, is stable and in hospital — where he will undergo further treatment — after going to ground with no one around him in the 59th minute of the game. He received medical attention before being taken off on a stretcher.

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Referee Simon Hooper then led both teams off the pitch at Bournemouth’s Vitality Stadium, before the game was later abandoned.

Lockyer previously suffered a medical emergency 12 minutes into the Championship play-off final at Wembley in May, when he was taken off on a stretcher after being treated by medical staff having gone down with no one around him.

After that incident, Lockyer was taken to hospital immediately and Luton confirmed shortly after that he was responsive. He left hospital four days later, before signing a new contract with Luton in July ahead of their inaugural Premier League season.

The defender had a successful operation and was cleared to train with his team-mates during pre-season. He said via club channels that he had an “atrial fibrillation”, which the National Health Service describes as causing “an irregular and often abnormally fast heart rate”.

What is cardiac arrest?

According to the British Heart Foundation (BHF), cardiac arrest is when the heart suddenly stops pumping blood. When this occurs, blood doesn’t flow to the brain or other important organs.

During cardiac arrest, the heart gets out of rhythm and suddenly stops beating. The person no longer has a pulse, stops breathing and becomes unconscious.

Unlike a heart attack, cardiac arrest is caused by an electrical disturbance that disrupts how the heart pumps blood throughout the body, ultimately stopping blood flow. There is not a blockage to the heart.

The BHF says a person suffering cardiac arrest will die without immediate treatment.

Is it common in young athletes?

While sudden cardiac arrest is the leading cause of death in young athletes, it’s still a rare occurrence. Some reports suggest that about one in 50,000-80,000 young athletes die of sudden cardiac death each year, according to the United States-based Mayo Clinic, noting that estimates vary.

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Every week in the UK, 12 apparently fit and healthy young people (aged 35 and under) die from undiagnosed cardiac conditions, according to Cardiac Risk in the Young (CRY).

In the general population, there are more than 30,000 out-of-hospital cardiac arrests in the UK each year, according to the BHF, with a survival rate of less than 1 in 10.

How common are cardiac arrests in football?

In 2021, Denmark midfielder and talisman Christian Eriksen collapsed on the pitch shortly before half-time during the nation’s European Championship opening game against Finland in Copenhagen.

It was subsequently confirmed that Eriksen suffered a cardiac arrest. Medical experts in attendance said the footballer’s heart stopped and they feared he was “gone” during the most traumatic moment in the history of the competition.

Thankfully, the proactive response from Eriksen’s team-mates, match officials and medical professionals resuscitated the midfielder, who resumed his football career six months later at Brentford and subsequently at Manchester United.

Eriksen was stopped from continuing his playing career at Inter Milan in Serie A after having an implantable cardioverter-defibrillator (ICD) fitted following his cardiac arrest as Italy does not allow footballers to play with a defibrillator.

Eriksen’s example of suffering a cardiac arrest and being able to continue playing is rare.

In March 2012, Bolton midfielder Fabrice Muamba suffered a cardiac arrest during a televised FA Cup match between his side and Tottenham.

Muamba’s heart stopped for 78 minutes but his life was saved. Following medical advice, he announced his retirement from professional football in August 2012. He later made a return to football as a youth coach.

In January 2004, Benfica striker Miklos Feher died after suffering a cardiac arrest caused by hypertrophic cardiomyopathy while playing against Vitoria Guimaraes.

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Three years later, Sevilla star Antonio Puerta collapsed during a match against Getafe. He died later in hospital after several cardiac arrests. An autopsy revealed arrhythmogenic right ventricular cardiomyopathy.

In 2009, Espanyol captain Dani Jarque passed away after suffering a cardiac arrest after a training session.

Fiorentina captain and Italy international defender Davide Astori was found dead in his hotel room ahead of a Serie A match in March 2018, with an autopsy later revealing he suffered a cardiac arrest.

Why is a quick response so crucial?

It can be the difference between life and death. When the heart stops pumping blood throughout the rest of the body, the brain doesn’t receive oxygen. Within four to six minutes there can be significant brain damage, so every second counts.

According to the Heart Research Institute UK, 90 per cent of the more than 30,000 cardiac arrests that occur outside hospitals each year in the UK are fatal.

When is CPR and AED used in these situations?

CPR (cardiopulmonary resuscitation) and an AED (automated external defibrillator) are needed when the heart stops beating. The combination of these two things can be life-saving if administered quickly when a person experiences sudden cardiac arrest.

What tests does someone go through after suffering cardiac arrest?

The person will go through a wide range of tests on all organs, but the heart and brain are typically the most important and most urgent. This will include chest X-rays, an echocardiogram and brain scans to check blood flow to the brain.

What is the FA’s protocol regarding cardiac arrest?

The Football Association (FA) has developed an online course to provide additional education and training on the use of AEDs and the topic of sudden cardiac arrest (SCA) in football. This course can be accessed here.

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Cardiac Risk in the Young (CRY) offers subsidised echocardiogram screening to young people between the ages of 14 and 35. If there has been a young (under 35) sudden death in the family, the family is entitled to be screened on the NHS. For the parents of a young player who dies as a result of such conditions, Cardiac Risk in the Young (CRY) can offer bereavement services through peer-to-peer support. There are also booklets written for bereaved families explaining more about conditions which can cause a sudden cardiac death.

(Top photo: Eddie Keogh/Getty Images)