By Kousik Krishnan, MD
Over the past several years, in very high-profile, large-city marathons, there have occasionally been deaths during races. They have occurred during the Chicago Marathon, the Philadelphia Marathon and even the Olympic Marathon Trials in 2007. These reports often bring to light an unusual paradox, where seemingly very healthy individuals are dying during athletic pursuits, when these same individuals are ostensibly healthy enough to go through the rigors of training for years without any incident.
Why are these individuals dying? Are they living with an undiagnosed condition that leads to the tragic result? Shouldn’t this condition have warning signs or symptoms? Is there something unique about the actual race that triggers an event that doesn’t become evident during normal training?
With this background, I was very interested in a recent article in the New England Journal of Medicine that analyzed the Race Associated Cardiac Arrest Event Registry (RACER). This registry collected data from the most recent decade of long-distance running races to determine the incidence, clinical profile, and outcomes of cardiac arrest in these events. The finding of this study show that the rate of cardiac arrest is actually very low (1 per 184,000 runners) and lower than cardiac arrest rates for college athletes, triathletes and previously healthy middle-aged joggers.