Sports Medicine

, Volume 37, Issue 4–5, pp 448–450 | Cite as

Marathon Cardiac Deaths

The London Experience
  • Dan S. Tunstall PedoeEmail author
Conference Paper


Data from the London Marathon, with 650 000 completed runs, show that cardiac arrests occur even in the most experienced runners. Although coronary artery disease was the commonest cause of sudden cardiac arrest (SCA) with five deaths and six resuscitations, hypertrophic cardiomyopathy or idiopathic left ventricular hypertrophy (HCM) was diagnosed at autopsy on three occasions. HCM deaths had the same average age as the runners with ischaemic heart disease who had SCA or sudden cardiac death. The cardiac arrests were at the finish in less than one-third of cases and the remainder occurred between 6 and 26 miles on the course. Only one of the eight runners who died had reported symptoms to his family or physician suggestive of cardiac disease. The runner who had reported pre-race angina pain was investigated with a negative exercise stress test prior to the marathon and despite this died with a left anterior descending coronary artery stenosis. The cardiac death rate for the London Marathon is 1 in 80 000 finishers.


Cardiac Arrest Sudden Cardiac Death Hypertrophic Cardiomyopathy Structural Heart Disease Marathon Runner 
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The author has indicated that he has no affiliation or financial interest in any organisation (other than the London Marathon) that may have a direct interest in the subject matter of this article.


  1. 1.
    Bassler TJ. Marathon running and immunity to atherosclerosis. In: Milvy P, editor. The marathon: physiological, medical, epidemiological, and psychological studies. Ann N Y Acad Sci 1977; 301: 579–92Google Scholar
  2. 2.
    Maron BJ. Sudden death in young athletes. N Engl J Med 2003; 349 (11): 1064–75PubMedCrossRefGoogle Scholar
  3. 3.
    Maron BJ, Poliac LC, Roberts WO. Risk for sudden cardiac death associated with marathon running. J Am Coll Cardiol 1996; 28 (2): 428–31PubMedCrossRefGoogle Scholar
  4. 4.
    Tunstall Pedoe DS. Sudden cardiac death in sport spectre or preventable risk? Br J Sports Med 2000; 34 (2): 137–40CrossRefGoogle Scholar
  5. 5.
    Tunstall Pedoe DS. Sudden death risk in older athletes: increasing the denominator. Br J Sports Med 2004; 38 (6): 671–2PubMedCrossRefGoogle Scholar
  6. 6.
    Tunstall Pedoe DS. Morbidity and mortality in the London Marathon. In: Tunstall Pedoe DS, editor. Marathon medicine. London: RSM Press, 2000: 197–207Google Scholar
  7. 7.
    Tunstall Pedoe DS. Marathon myths and marathon medicine. In: Tunstall Pedoe DS, editor. Marathon medicine. London: RSM Press, 2000: 3–14Google Scholar

Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  1. 1.LondonUK

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