Sudden cardiac death (SCD), a very quick unexplained death due to the loss of heart function, is the leading medical cause of death in athletes.
As both an underwriter and an athlete, this sounds scary!
I’m female, I’m in my 30s, I don’t smoke, I (mostly) eat well, and I don’t have any typical risk factors for heart disease such as diabetes, obesity, or a sedentary lifestyle. For the general population, this puts me in a very low risk category, but… I’m a runner.
Does being an athlete put me at higher risk for sudden death?
I’ve heard many people (usually non-runners) say that long distance running is a risky sport, even going as far as calling it dangerous, and that the incidence of people “dropping dead” in a marathon is proof of this claim.
Some of these anti-runners (or, I guess, they are probably concerned individuals, who are likely even loved ones) might use the story of the history of the marathon, which is quite possibly a myth, as “proof” of the apparent high cardiac risk of running 26.2 miles (42.2 km). If you haven’t heard the story before, here’s the brief:
Back in 490 BC, the Athenians won the Battle of Marathon against the Persian army. To bring the news of the victory to Athens, a messenger named Pheidippides was instructed to run the ~26 miles from Marathon to Athens. He ran all the way to Athens, let the people of Athens know that they had won, and then he collapsed and died.
Is the story true? I have no idea, but it is one that I have heard regularly and one that has made me wonder… if there is truth to the story…. was Pheidippides just not physically prepared to run that distance? Did he lack cardiorespiratory fitness? This seems unlikely.
If he was a messenger in Greece in 490 BC, he would have been a runner by trade: a professional runner, so to speak. I’m also guessing most of his jobs weren’t to make deliveries just a couple of kilometers away; people could deliver those messages themselves! So, scratching that option off the list…
Did he have an unknown underlying medical condition? This is much more likely.
Back to modern times…. November 3rd, 2007. New York City. US Olympic marathon trials. That morning, at 7:30 am, 28-year-old Ryan Shay toed the line with many other worthy competitors, to race for one of three coveted spots on the 2008 US Olympic Team, to compete in the marathon.
His qualifying time was 2:14:58, an average pace of around 5 minutes and 8 seconds per mile, which translates to running a 5-km race in under 16 minutes - something most people will never do.
He ran marathons at that incredibly quick pace. He was an accomplished runner. He was fit.
As you may have noticed, I said “was.” That day in November did not become the day that Ryan Shay gained his place in history by earning a spot on the Olympic team. Instead, his spot in history was made when he collapsed around 5.5 miles into the race (8.9 km), was taken to hospital, and was pronounced dead just 40 minutes later.
Although you may not have heard of this specific instance, I’m sure we’ve all heard of those shocking situations where a high-profile athlete has collapsed and died in the middle of a basketball game, a football game, or while playing hockey.
Do athletes fall victim to sudden cardiac death more often than the average person?
More people are aware of the occurrence of sudden death in athletes because it comes as a surprise and attracts media attention. Nobody expects the young, healthy, fit individual to be the one to suddenly die with no apparent explanation and no known risk factors.
It is easy to view the intense exercise as the problem in these situations. I mean, this is what separates the high-level athlete from the rest of us, right?
The sudden death of an athlete is often brought to the spotlight as a newsworthy event, especially if that athlete was competing at the time of death. Meanwhile, the sudden cardiac death of a nonathlete who dies in their home, away from cameras and journalists, does not gain much attention at all.
A 10-year study was done in the US (2002 to 2011) to determine the incidence of sudden death in collegiate athletes around age 20. In this 10-year period, there were 182 deaths, out of over 4 million athletes in 30 sports. Of the 182 deaths, 64 were likely due to cardiovascular causes. 47 of the 64 were confirmed to be cardiac on autopsy.
The most common cause was hypertrophic cardiomyopathy (21), and congenital defects (8). The incidence of cardiovascular cause of sudden death was 1.2 per 100,000.
So… are athletes at increased risk for sudden cardiac death?
- Some fast facts on young athletes,
- How the risk of sudden cardiac death can double when a person is exercising,
- And how cases of SCD are almost always linked with pre-existing conditions.