“I heard about a marathoner who had a heart attack at the finish line…”


Austin is a fit city, for sure. Everywhere you go, people are in spandex or wicking workout gear and look really fit. There are countless opportunities for exercise and adventure. Just when you decide to get on the bandwagon, you hear about someone who had a heart attack after running the Austin Marathon. How does that happen?  em>Why bother with fitness when it doesn’t prevent heart disease@f0

Case in point: The world famous ultra-marathoner, Micha True (a.k.a. Caballo Blanco), was recently found in the Gila National Forest having died while on a trail run. He was a man who ran 50+ miles at a time – many times over. His autopsy report as summarized in Runner’s World stated his cause of death was related to dilated cardiomyopathy.

Again, WHY did it happen?

1. His heart disease was not coronary artery disease caused by plaque build-up. He had a weak heart that is not always caused by lifestyle choices (smoking, poor diet, lack of exercise), but it can be the result of a virus that attacks the heart. Regular exercise cannot prevent this type of heart disease.

2. Caballo Blanco’s death is thought to be due to his underlying heart condition and dehydration. He may well have had a sudden, fatal heart arrhythmia.

My take home message as a physician is:

–  Any new symptoms of fatigue, shortness of breath, or palpitations need to be evaluated. Even in athletes. Maybe a patient was fine running 10 miles, now she’s stopping at 6. This is great for most people, but not for this patient. I’ll remember to ask specifics about overall endurance. I’ll not assume that completing regular exercise means my patient has a healthy heart.

My take home message as a runner is:

– Listen to my body. Exercise does not prevent all heart disease, but it does save lives. Being fit and healthy gives me a better chance no matter what medical issues may come up. However; If I am not completing my regular work outs with the same ease, I will talk to my doctor. I am not just tired because I am working full time, taking care of kids and keeping the family organized.

Bottom Line: join the bandwagon. Every little bit counts when it comes to exercise.