Scott McTominay's Heart Condition: What It Means and When He'll Be Back

Napoli and Scotland midfielder Scott McTominay, 29, will miss more than a month of football after doctors found he needs a minor heart procedure. The condition is called a mild, benign arrhythmia, which means his heart sometimes beats in an unsteady or irregular way. McTominay was substituted during Napoli's 2-1 loss to Como last weekend, and the club confirmed he will have surgery next week. After hearing the news, McTominay posted on Instagram: "See you soon, Napoli. I won't be long."

McTominay is not the first professional footballer to face a heart issue. Former Liverpool player Adam Lallana had surgery for the same type of condition when he was just 16 years old, and he went on to play more than 500 senior games. Portsmouth striker Colby Bishop returned after open-heart surgery, and former Brighton defender Connor Goldson had open-heart surgery for an enlarged part of his heart. Christian Eriksen, Daley Blind, and Tom Lockyer have all gone back to playing after having a small device fitted inside their bodies that can shock the heart back to a normal rhythm if something goes wrong.

Heart screening — the process of checking players' hearts for hidden problems — is very common in elite sport. England's football screening programme is one of the most thorough in the world and began after the death of 16-year-old John Marshall in 1995. Marshall suffered a heart attack caused by an undiagnosed condition and was due to sign for Everton the very next day. His death led the PFA, which is the players' union in English football, to start a screening programme for all young players in the country.

Today, young players in England go through two key tests. The first is an electrocardiogram, or ECG, which measures the electrical signals in the heart. The second is an echocardiogram, which uses sound waves to create a moving picture of the heart so doctors can check its shape and how it works. Together, these tests can detect up to 85% of serious hidden heart conditions, sometimes called "silent killers" because most people show no warning signs before a cardiac arrest.

Research by Professor Aneil Malhotra of Manchester Metropolitan University found that about one in every 250 elite footballers has a serious heart condition. In the general public, a charity called Cardiac Risk in the Young found that about one in every 300 people aged 14 to 35 has a life-threatening heart condition. For minor conditions, about one in every 50 footballers is affected. The good news is that 75% of players diagnosed with a serious condition were able to return to playing after proper treatment.

McTominay's arrhythmia is thought to be genetic, meaning he was likely born with it. It was first found before he joined Napoli in 2024, but doctors did not think he needed surgery right away. Recently, wearable technology that tracks his heart showed some higher-than-normal readings, so doctors decided it was the right time to operate. Because there is an international break coming up in the football calendar, Napoli expect him to miss as little football time as possible.

The surgery McTominay needs is called a cardiac ablation. During this procedure, doctors use heat or cold energy to create tiny scars inside the heart that block the faulty electrical signals causing the irregular heartbeat. Professor Malhotra uses a traffic analogy to explain it: the scars stop "side street traffic" from hijacking the heart's main electrical road. This helps the heart go back to beating in a normal, steady rhythm.

After surgery, players do not jump straight back into full training. Professor Malhotra says a recovery of two to four weeks is normal, followed by a slow return to exercise. The mental side of recovery is just as important as the physical side, as players often worry about pushing themselves too hard or whether their condition might return. "Confidence often returns progressively as they resume training, reach higher intensities and remain symptom-free," said Professor Malhotra.

After heart surgery, most players are monitored closely using a small device worn on the chest that tracks the heart's rhythm during sleep and exercise for up to seven days or more. Players might also be tested on a treadmill or exercise bike to make sure their heart is working well before they return to competitive games. In Italy, the rules about returning to sport after a heart issue are especially strict, partly because of the deaths of two Italian footballers in past decades.

McTominay will miss Scotland's upcoming Nations League matches against Switzerland, North Macedonia, and Slovenia. This is a tough moment for new head coach Sebastien Pocognoli, who was hoping to start his time in charge with strong results. McTominay has scored 15 goals in 73 appearances for Scotland, making him one of the country's most important players. Aston Villa's John McGinn, who has 21 international goals, will likely need to take on more of an attacking role while McTominay recovers.