Friday, December 24, 2010

Cardiac Concerns in Marathon Runners

Cross posted from

Last week I gave a lecture for the Division of Cardiology at UF on the "Cardiac Concerns of Marathon Runners". The topic seemed a natural fit for me and I think most know that it is much easier to give a quality talk about a topic that you are interested in. I started my research for the talk by searching PubMed, which is the National Library of Medicine's web interface to access their database of medical literature. For medical research, it is basically the standard place to start a high quality search on any given subject in medicine. From there I branched out into searching for articles on marathon running in several prominent sports medicine, general medicine, and cardiology journals.

After collecting dozens of articles, I separated them into three general groups/topics around which I built my talk. First, the cardiologist perspective on pre-participation screening. Anyone who did sports in high school likely remembers having to get a doctor to clear you to participate. Well, grown-ups, especially those starting a new exercise program should do the same and there are some specific guidelines about what kinds of questions your doctor should ask and maybe a few tests that she/he should order for you.

Second, I talked about the adaptation to endurance sports. There are a lot of changes that go on in the body to make you better at your chosen sport. For cardiologists, one of the most important is the fact that your heart (a muscle) tries to grow stronger as you challenge it more and more. This means your heart may change size and shape. Now, this part is normal, but what is sometimes very challenging is for cardiologists to know the difference between your heart changing shape because you are an athlete, or your heart changing shape because you have some type of dangerous heart condition (ie: cardiomyopathy). In my talk I cover some of the important ways to tell the difference.

Third, I talked about the risks of being a runner, especially when you are out running. There are a lot of blood tests and imaging tests of the heart that show that during a run, some strange things can go on with the heart. The important part is that no one has yet shown that these strange things are actually dangerous. That said, there are some very real dangers, like the risk of arrhythmias, heart attacks, and sudden death while out running. Clearly, tragic incidents like that of Ryan Shay should make it clear that there are some risks to endurance sports, but the good news (to very briefly summarize) is that the higher risk of having a problem during a run  is far outstripped by the dramatic benefit you get from being a runner (ie: preventing heart attacks, preventing disability, and on average living longer.)

At some point I'll try and delve more into the details of my talk, but in the meantime, Happy Holidays!

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