Matters of the Heart: Risking it All for the Marathon

How Far Should You Go?

Does that mean that pushing hard in training and in a marathon is detrimental to a person's health? The answer to that question varies greatly among individuals. Should you be more worried about your own marathon running in light of the recent heart attacks and deaths in marathons? That depends greatly on your age, family history and personal health profile. When it comes to the heart, making generalizations based on the general population is tricky and often misleading. Despite the voluminous research that has been done through the years on the heart, exercise and stress, there are still many unknowns.

As for sudden cardiac arrest not related to CAD, that can be even trickier to diagnose and treat, especially in young athletes who are not in pain and exhibit no symptoms other than an enlarged heart.

Dr. Paul Thompson, a cardiologist who specializes in heart disease in athletes, says most elite athletes have hearts that are enlarged by exercise. The key is to determine whether the walls of the heart are thicker than normal, forcing the heart to work harder to pump blood. Thicker walls could be a sign of a potentially dangerous condition called hypertrophic cardiomyopathy, abnormal coronary arteries or an inherited disease that causes heart tissue to pull apart, called arrhythmogenic right ventricular cardiomyopathy.

Although Shay was diagnosed with an enlarged heart, he passed extensive performance tests twice a year with passing colors. Who would want to advise an aspiring elite such as Shay to stop training and racing based on the outside possibility that he might be susceptible to SCD? Again, it is a matter of assessing the odds, something no one wants to do when it comes to deciding whether or not to continue doing something they love.

The more information you can accrue from testing, the better you will be able to determine if you are at risk. That said, testing is not infallible and even in this day and age of advanced technology in medicine, most tests cannot offer incontrovertible evidence.

Life is full of very small daily risks that we assume in order to do the things we enjoy, or do the things that are a part of our daily routine--such as eating breakfast or pulling the car out of the driveway onto the highway. Most of the time, these activities will prove harmless, but probability studies show that your chances of dying in a car accident are far greater than your chances of dying while running a marathon.

Training for and competing in a marathon offers a heightened sense of challenge, excitement and fun. As has been said before, training and racing can add life to your years, if not years to your life. It just doesn't translate into statistics and probability.

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Don Allison, from Weymouth, Massachusetts, is the former publisher of UltraRunning Magazine and a founder of Cool Running. He has completed 55 marathons, with a personal best of 2:35. In addition, Don has completed several ultramarathons, Ironman triathlons and cycled across the U.S.A. in 2006.

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