Patrick van Aanholt withdrawn from Sunderland team on Sunday due to heart problems

Sunderland defender Patrick van Aanholt was withdrawn from the starting line-up against Tottenham on Sunday after the club were informed of results of his cardiology tests by the FA.

David Moyes confirmed the news on Tuesday after the left-back seemed bemused and frustrated when he was told by his replacement Jason Denayer in the warm-up he was no longer playing.

Under FA and Premier League rules, a player can only be replaced after the submission of the team-sheets on medical grounds, although the 26-year-old's reaction, where he was caught on television cameras kicking the ball away in frustration, raised suspicion about what the reason was.

And when asked to explain why Van Aanholt was replaced, Moyes responded coyly.

“I've given a stock answer: for medical reasons, we chose to withdraw him from the game. If you don't mind, I won't follow up,” he said after the game.

“You know me, I'd always like to be straight but I'm giving you what I think the best answer right now is.

"We advised the referee. It was very late on, I got word of something very late obviously, and because of that, that affected the decision.

“As you well know, people can get injured in the warm-up.”

However, it his pre-match press conference for Sunderland’s EFL game with Queens Park Rangers on Wednesday, Moyes confirmed Van Aanholt’s withdrawal was due to results of a cardiology exam, and not any suspicious circumstances.

He also confirmed the FA were heavily involved in the decision to stop the Dutchman from playing but couldn’t understand why they waited so late to contact the club with the results.

He said: "He had the statutory checks with the cardiologists and the FA panel of cardiologists looked at it and advised us really late on Sunday that he should not play until further tests had taken place.

"We are just surprised that the FA panel didn't contact me or contact my doctor until 3.55pm on Sunday afternoon. I have never in my career been put in a situation like that ever, so we had that to deal with.

"We just can't understand why the message would come to us at that time, 30 minutes before the kick-off.

"It was completely outside our control, but it was in our control because we knew we had to make the correct decision for the player and for the football club. We had to do that."

Van Aanholt has now had further tests in London and Moyes has confirmed the defender will travel with the rest of the squad to QPR but no decision will be made on whether he plays or not until tomorrow.