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Marathon cardiac deaths : the london experience
1DanTPMARDR@aol.com
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Sudden cardiac arrests can affect even experienced runners during marathons. Coronary artery disease and hypertrophic cardiomyopathy are key causes, with most events occurring on the course, not at the finish line.
Area of Science:
- Cardiology
- Sports Medicine
- Public Health
Background:
- Marathon running is associated with cardiovascular events, including sudden cardiac arrest (SCA).
- Understanding the causes and circumstances of SCA in marathon runners is crucial for prevention and emergency response.
Purpose of the Study:
- To analyze the incidence, causes, and timing of sudden cardiac arrests in London Marathon participants.
- To identify risk factors and characteristics of runners experiencing SCA during the event.
Main Methods:
- Retrospective analysis of data from 650,000 London Marathon completions.
- Review of autopsy findings and medical histories for fatal and resuscitated cardiac arrest cases.
Main Results:
- Coronary artery disease was the most frequent cause of SCA, followed by hypertrophic cardiomyopathy (HCM).
- Cardiac arrests occurred throughout the marathon course, not solely at the finish line.
- Most fatalities occurred in runners who had not reported prior cardiac symptoms.
Conclusions:
- Sudden cardiac arrest is a risk in marathon running, affecting even elite athletes.
- Both ischemic heart disease and HCM are significant causes of SCA in this population.
- Pre-participation screening may not identify all at-risk individuals, highlighting the need for continued vigilance and research.
Abstract:
Data from the London Marathon, with 650,000 completed runs, show that cardiac arrests occur even in the most experienced runners. Although coronary artery disease was the commonest cause of sudden cardiac arrest (SCA) with five deaths and six resuscitations, hypertrophic cardiomyopathy or idiopathic left ventricular hypertrophy (HCM) was diagnosed at autopsy on three occasions. HCM deaths had the same average age as the runners with ischaemic heart disease who had SCA or sudden cardiac death. The cardiac arrests were at the finish in less than one-third of cases and the remainder occurred between 6 and 26 miles on the course. Only one of the eight runners who died had reported symptoms to his family or physician suggestive of cardiac disease. The runner who had reported pre-race angina pain was investigated with a negative exercise stress test prior to the marathon and despite this died with a left anterior descending coronary artery stenosis. The cardiac death rate for the London Marathon is 1 in 80,000 finishers.
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