“The reason the Tour de France is one of the hardest sporting events in the world is that we race in the peak of summer and it’s all about attrition,” Luke Durbridge of Jayco-AlUla, veteran of 12 Tours, says.

Three weeks of intense racing, often under the baking hot sun, provides a thrilling spectacle, but it also poses dangers for the 184 riders: injuries, illnesses, burnout and more severe issues such as cardiovascular problems can afflict them.

In the past decade, WorldTour riders Nathan Hooydonck (Jumbo-Visma, 2023), Wesley Kreder (Cofidis, 2023) and Sonny Colbrelli (Bahrain-Victorious, 2022) have all suffered cardiac arrests and been forced to retire prematurely from cycling. Others, including Elia Viviani (Cofidis, 2021), Zdeněk Štybar (Deceuninck Quick-Step, 2021) and Peter Sagan (Pierre Baguette, 2024), have detected problems and had minor heart surgery. Sam Bennett, the Tour’s 2020 green jersey winner, also had a heart scare recently.

Tour de France cyclists are some of the fittest athletes on the planet – but what they do is not normal. They require close medical attention to ensure that they’re not pushing beyond their limits. At the start of every season, riders undergo a mandatory heart examination, while additional check-ups take place periodically. Just like the general population at large, cyclists cannot take any chances with their heart.

“I’d say that only checking your heart once a year is not enough,” explains Netcompany-Ineos’s former world champion Michał Kwiatkowski. “That’s what happened in the past but with all the daily checking now I feel much safer. The last thing we want is to not wake up in the morning after not being diagnosed with something.”

This article was published by Cycling Weekly in July 2026. To read the full article click here.