Sunderland boss David Moyes has revealed that Patrick van Aanholt was pulled out of the starting XI for Sunday's Premier League clash with Tottenham Hotspur due to the results of a cardiology test.

The full-back was initially named in Moyes's starting team at White Hart Lane, only for Jason Denayer to appear for kickoff in a decision that was not fully explained after the match.

However, Moyes has now confirmed that the withdrawal was down to 'medical reasons' after the Football Association panel of cardiologists advised that the defender should not feature "until further tests had taken place".

"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," Moyes told reporters.

"We are just surprised that the FA panel didn't contact me or contact my [club] 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."

Sunderland will take on Championship side Queens Park Rangers in the third round of the League Cup on Wednesday night. Van Aanholt will travel to London, but his involvement is doubtful.