Every professional athlete in Italy—whether signing a contract or undergoing a transfer—must complete mandatory medical exams at an accredited sports medicine center. If any red flags emerge, a specialist steps in for a deeper review, often focusing on cardiac function. The process leaves no room for negotiation: either the athlete is cleared to play, or they’re barred from competition.

A history of strict medical oversight

Italy’s stringent approach dates back to 1982, when the Ministry of Health designated specialized centers to oversee athlete health. A 1995 decree further tightened regulations, introducing advanced cardiac evaluations like echocardiograms and stress tests. “Our protocols may seem overly cautious to some, but they’re a matter of ethics,” explains Paolo Zeppilli, former sports medicine professor and longtime Italian Football Federation cardiologist. “We won’t allow an athlete to risk their life on the field. Other leagues should adopt stricter standards.”

Real-world consequences

The policy has real-life implications. Italian midfielder Edoardo Bove, who suffered a cardiac arrest during a Serie A match, was fitted with a defibrillator and permanently barred from playing in Italy—though he later resumed his career in England, where rules differ. Similarly, Denmark’s Christian Eriksen, who collapsed during Euro 2021, was cleared for play in the Premier League after Italian authorities deemed him unfit for Serie A. Tragically, Eriksen suffered another cardiac episode in June while playing for his national team.