Dr. Paul D. Thompson, MD, explains how he sees heart risk for recreational marathon runners, when a runner should see a doctor, where in the race the largest number of events occurred, and why runners should learn CPR.
Marathon Running and Heart Risk: Pacing, Symptoms, and CPR
Jump To Section
- Why marathon deaths draw attention
- Seeing a doctor before a marathon
- Events late in the race
- Training gradually
- Learning CPR
- Full Transcript
Why marathon deaths draw attention
Heart risk during marathon running is really quite low, according to Dr. Paul D. Thompson, MD. Dr. Anton Titov, MD, asks what a recreational runner should know, citing the registry study Dr. Thompson co-authored on cardiac arrest during marathons and half marathons.
Dr. Thompson says these events are quite rare but feel paradoxical. We expect these runners to be the healthiest, so a death during a marathon or sporting event upsets us and draws a lot of attention.
Seeing a doctor before a marathon
A visit to a doctor before a marathon is not necessarily needed, in Dr. Thompson's opinion, unless a runner has symptoms. He considers paying attention to yourself the most important thing. New symptoms mean seeing a doctor, and he quotes the saying that a person who is his own doctor has a fool for a patient.
Events late in the race
The timing of events was a very interesting finding in Dr. Thompson's study of deaths during marathons. He says the largest number of events happened in the last 25% of the race course. He thinks this is probably because people speed up, want to show off for their family and push too hard.
Training gradually
Going slowly during exercise training is his main advice. Dr. Thompson suggests not running too far in the first week or so, and building up step by step, in baby steps.
Learning CPR
Learning cardiopulmonary resuscitation (CPR) is his other recommendation for marathoners and racers. A runner cannot perform CPR on themselves, he notes, but can use it to help another person who collapses during a run or exercise.
Dr. Thompson does not want to make too much of the danger. Exercise is overall beneficial to health, he says, but occasional episodes happen, and runners want to be ready for them.
Full Transcript
Dr. Anton Titov, MD: Marathon running and the heart, cardiac arrest in marathon runners. You co-authored the registry study of cardiac arrest during marathons and half marathons. Cardiac arrest was rare and occurred mainly in men running full marathons. The most common causes were hypertrophic cardiomyopathy and coronary artery disease. Professor Thompson, what should a recreational marathon runner know about heart risk? Who should see a cardiologist before a marathon?
Dr. Paul D. Thompson, MD: The risk of exercise is really quite low. It is made a big deal. We make a big deal of it because if anything happens, it is paradoxical, right?
Dr. Paul D. Thompson, MD: We expect these people to be the healthiest. So if somebody dies during a marathon, if somebody dies during a sporting event, that upsets us, and so we pay a lot of attention to it. But actually, these events are quite rare.
Dr. Paul D. Thompson, MD: I do not think anybody necessarily has to see a doctor before a marathon unless you have symptoms. The most important thing is to pay attention to yourself. If you have new symptoms and stuff like that, then you should see a doctor.
Dr. Paul D. Thompson, MD: Now, in the study we did looking at deaths during marathons, a very interesting finding occurred. The largest number of events happened in the last 25% of the race course. They happened in the last quarter of the race course.
Dr. Paul D. Thompson, MD: That is probably because people speed up; they want to show off for their family, they want to push too hard. So the most important thing about it is to go slowly during your exercise training. Do not go out and run too far the first week or so.
Dr. Paul D. Thompson, MD: Go slow, step by step, baby steps. And then pay attention to yourself. If something happens, if you have new symptoms, do not be the doctor.
Dr. Paul D. Thompson, MD: Go see a doctor. The other thing I think is important is that if you are a marathoner or a racer, you should learn CPR. Not because you are going to do CPR on yourself (you cannot do that), but cardiopulmonary resuscitation can help you resuscitate some other person if they collapse during a run or exercise.
Dr. Paul D. Thompson, MD: Now remember, I do not want to make too much of this. We make too much out of the risks of exercise. Exercise is overall beneficial to your health, but there are occasional episodes, and you want to be ready to deal with them.
Dr. Paul D. Thompson, MD: If you have symptoms, do not be your own doctor. We always say that the person that has himself as his doctor has a fool for a patient. I hope I said that right.
Dr. Paul D. Thompson, MD: But the point is, if you try to be your own doctor, you are a bit of a fool.