Christian Eriksen is carried off after on-pitch treatment
It was a moment which left the football world paralysed with shock: Christian Eriksen, one of the faces of the tournament, collapsing to the turf in the 42nd minute of Denmark’s European Championship opener against Finland in front of a disbelieving Parken Stadium in Copenhagen.
For several minutes, as medics desperately attended to the former Tottenham midfielder, it was easy to fear the worst. And yet Eriksen, like Fabrice Muamba before him in 2012, appears to have got the right treatment in time. Here Telegraph Sport explores what happened on Saturday night, and examines whether the stricken Inter Milan player is likely to play again:
What happened to Christian Eriksen
At around 5.42pm UK time, one of the finest players ever to set sail from Danish football nearly died. There were fewer than four minutes to play until half-time when the bona fide star of the Premier League during his seven years at Tottenham Hotspur collapsed on the turf while the ball was out of play by the Finnish corner flag.
Instantly, players from both sides, some of them eventually shocked into tears, called for medical attention. Even before the Danish medical teams had arrived, Eriksen’s team-mates were clustered around him. Once the medics arrived, they soon began to perform a heart massage on the player. A silence fell over the half-full stadium.
The Finland players came back to the touchline by the coaching areas. Eventually the Denmark manager, Kasper Hjulmand, walked across the empty pitch to his players. The BBC stopped TV transmission of the traumatising scenes but some European channels continued showing footage.
Denmark manager, Kasper Hjulmand
"We were called on the pitch when Christian fell down – I didn’t see myself but it was pretty clear he was unconscious," Denmark’s team doctor Martin Boesen explained. "When I get to him, he’s on his side. He is breathing and I can see [a] pulse but suddenly that changes, and as everyone saw we started giving him CPR.
"The help came really, really fast from the medical team and the rest of the football staff, and with their cooperation we did what we had to do."
During approximately 15 minutes of on-field treatment a white tent structure had been erected around the Inter Milan star before he was eventually carried off on a stretcher.
Eriksen is taken off and is shielded from view
Supporters from both countries then chanted his name while both sets of teams spent the next hour in their dressing rooms. At 6.31pm UK time, the DBU announced that Eriksen was awake and undergoing further examinations at the nearby Rigshospitalet. The players were informed he wanted the match to continue and, as a result, Kasper Schmeichel then led the players out again and the match kicked off again at 7.30pm, with a subdued Danish side slipping to a 1-0 defeat.
How the Denmark midfielder’s life was saved
As Gary Lewin, the former England and Arsenal physio observed, your chances of heart attack survival are significantly higher at an elite footballing venue than they would be in the street. Doctors were effectively helping keep him alive within a matter of seconds, with equipment levels akin to a makeshift army field hospital.
Two cardiologists, speaking to Telegraph Sport on condition of anonymity, say they believe Eriksen suffered cardiac arrest on the basis he underwent CPR and regained normal cardiac rhythm with the help of defibrillation. One said it would appear his heart was restarted within ten minutes. By the time he was taken off the pitch, he had his head up and his eyes were open.
Uefa said that he was then swiftly transferred to hospital and stabilised, while the Danish FA said that he was awake in hospital and undergoing tests. By the end of the night Eriksen was able to speak to his team-mates over the phone. Dr Sam Mohiddin, who treated Bolton Wanderers’ Muamba after he collapsed during a match in 2012, told the BBC news channel the scenes should encourage the public to learn CPR. “The cardiac arrest is a moment of extreme peril," he said. "If you don’t get someone out of cardiac arrest things are over. You will not survive. The ongoing risk to an individual to an extent depends on the precise cause of that cardiac arrest."
The "moment of extreme peril", he explained, "is the time of the cardiac arrest and treating that is a matter that requires people to promptly recognise what is happening and really address it quickly with CPR and a defibrillator".
What could have caused the collapse
As devastating as it was for his family and a watching football world, Eriksen’s collapse was a statistical inevitability. A major international tournament had been due such a horror, with up to seven in every 100,000 athletes destined to suffer cardiac failure while in action.
Eriksen is most likely to have suffered a similar fate to Muamba, who had no previously known heart condition when he collapsed. Former Newcastle midfielder Cheick Tiote died during a training session following a cardiac arrest in 2017 while Marc Vivienne Foe, Phil O’Donnell, Antonio Puerta, Miklos Feher and Samuel Okwaraji are among those professional players who have died during matches following heart attacks.
The biggest risk to any athlete below the age of 30 is sudden cardiac arrest, and usually a condition called hypertrophic cardiomyopathy, which causes an abnormal heart rhythm. This is often an inherited condition when the walls of the heart muscle thicken. The thickened muscle can disrupt the heart’s electrical system, leading to fast or irregular heartbeats, which can in term lead to sudden cardiac arrest. Rigorous screening takes place in professional sport but a host of studies have shown it is not possible to spot all heart abnormalities.
Fabrice Muamba is treated by medical staff in 2012 – he had been screened earlier in his career
A study of British footballers aged 16 was conducted between 1996 and 2016 and delivered some quite alarming results. Out of 1,168 people, the study found that 42 had cardiac diseases that could cause sudden cardiac death, despite having presented with barely any symptoms prior to the test.
Thirty out of the 42 players had surgery or other treatment for their heart defect and were able to go back to playing football, but the other 12 stopped playing.
The study, which was published in the New England Journal of Medicine, calculated that the incidence of sudden cardiac death was 6.8 per 100,000 athletes. Most were due to hypertrophic cardiomyopathies that had not been detected on screening.
Indeed, more than 80 per cent of players with a potentially dangerous heart condition showed no signs of symptoms, while up to 20 per cent of players who are screened will still be given the all clear. Screening, then, is an important tool to limit rather than eliminate risk. Muamba himself had been screened during his career before the Tottenham match.
"It is very difficult to prevent cardiac arrest," said Muamba. "All [doctors] can do is train themselves to the maximum that when they find themselves in that situation, they know what they are dealing with and know how to cope with whatever scenario."
Reacting to seeing Eriksen stricken, Muamba told the BBC: "It brought back stuff that I have put down in me, the emotions I have just had deep down in there and never wanted to relive it again. It’s horrible. To watch it from that distance and not knowing what was going to happen – it’s scary."
Reaction from around the world
The Duke of Cambridge, England captain Harry Kane and Denmark manager Kasper Hjulmand were among thousands who penned messages of support to Eriksen. "Encouraging news about Christian Eriksen, we are all thinking about him and his family," said Prince Wiliam, who is president of the FA. “Well done to the medical team and Anthony Taylor for their calm and swift action."
The FA had cancelled a pre-Croatia press conference while Eriksen’s fate was uncertain, but Kane, who played with the 29-year-old for many years at Tottenham, later tweeted: “Chris. I’m sending all my love to you and your family. Stay strong mate.”
Encouraging news about Christian Eriksen, we are all thinking about him and his family. Well done to the medical team and Anthony Taylor for their calm and swift action. W
— The Duke and Duchess of Cambridge (@KensingtonRoyal) June 12, 2021
A spokesperson for the BBC issued an apology after pictures of Eriksen were broadcast while he received treatment. Gary Lineker, who was presenting the match, later added that “in 25 years of doing this job, that was the most difficult, distressing and emotional broadcast I’ve ever been involved with… Thanks to (pundits in the studio) Cesc Fabregas, Alex Scott and Micah Richards for your professionalism, warmth and empathy."
Hjulmand, meanwhile, was in tears at the post-match press conference.
“It was a tough night,” he said. “We are all reminded what the most important thing in life is and that is to have valuable relations. We have a group of players I can’t praise enough. I couldn’t be prouder of these people who take such good care of each other at such a time where one of my very, very dear friends is suffering.”
Gareth Southgate added “on behalf of The FA, our players and staff, we send our very best wishes to Christian and those close to him,” while Uefa President Aleksander Ceferin added: “Moments like this put everything in life into perspective. I wish Christian a full and speedy recovery and pray his family has strength and faith."
Danish paper Ekstra Bladet summed up the mood, with the online headline: Denmark lost, life won.
Front page of Danish paper @EkstraBladet online right now:
But life wonhttps://t.co/s0pcdBBzCE pic.twitter.com/cIAhwqNROI
— Lars Sivertsen (@larssivertsen) June 12, 2021
What next for Eriksen
Eriksen was said to be responsive in hospital on Saturday night, with Inter Milan CEO Giuseppe Marotta confirming that he had been in touch with the club’s players.
“Eriksen himself sent a message in our internal chat and this confirms the bond between the players,” he told Rai Sport.
In the longer term, this does not necessarily the end of Eriksen’s playing career. One cardiologist pointed to advancements in treatments in the nine years since Muamba collapsed 43 minutes into Bolton’s FA Cup tie against Tottenham. If, as suspected, it is heart failure, doctors will spend the next weeks effecting "looking at electricity running through the heart", with operations considered to block abnormal pathways. "It’s just too early to tell," said one heart specialist.
Muamba was forced to retire from football but has been able to live a relatively normal life with a special defibrillator pacemaker. He now campaigns for better screening of athletes. "Before the incident, I thought that my heart was beating fine and that there were no problems – the incident has taught me so much about my heart," he said.
"For young players, their head is all about football. When I was in football I know what it is like to be in that bubble where you don’t want to share information. Young players don’t pay attention to it, so we have to educate more players to it.
"So with those that get onto the football ladder it is important that when they get screened they study their own heart to get a better understanding of it."
Mandatory heart screening for all young adults who participated in sports has been introduced in Italy, which has resulted in an 89 per cent reduction in sudden cardiac death.