Sudden Death During Triathlons: The Heart of the Swim
Authors: Reginald T. Ho, Karen Glanz
Journal: Annals of Internal Medicine (2017)

Editorials17 October 2017Sudden Death During Triathlons: The Heart of the SwimReginald T. Ho, MD and Karen Glanz, PhD, MPHReginald T. Ho, MDFrom Thomas Jefferson University Hospital and University of Pennsylvania; Philadelphia, Pennsylvania.Search for more papers by this author and Karen Glanz, PhD, MPHFrom Thomas Jefferson University Hospital and University of Pennsylvania; Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The first recorded episode of sudden death in an athlete occurred in 490 BCE after the Battle of Marathon, when the Greek soldier Pheidippides ran 26 miles to Athens to proclaim Greece's victory over the powerful Persian army, collapsed, and died. Little attention, however, was paid to athletes dying suddenly until 1976, when 2 collegiate basketball players from the University of Maryland died unexpectedly within 2 months of each other (1). Since then, the emotional and highly publicized deaths of several other athletes, most notably Hank Gathers and Reggie Lewis, have captured the nation's attention and kept this issue in ...References1. Maron BJ. Historical perspectives on sudden deaths in young athletes with evolution over 35 years. Am J Cardiol. 2015;116:1461-8. [PMID: 26394831] doi:10.1016/j.amjcard.2015.07.072 CrossrefMedlineGoogle Scholar2. Albert CM, Mittleman MA, Chae CU, Lee IM, Hennekens CH, Manson JE. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med. 2000;343:1355-61. [PMID: 11070099] CrossrefMedlineGoogle Scholar3. Schnohr P, O'Keefe JH, Marott JL, Lange P, Jensen GB. Dose of jogging and long-term mortality: the Copenhagen City Heart Study. J Am Coll Cardiol. 2015;65:411-9. [PMID: 25660917] doi:10.1016/j.jacc.2014.11.023 CrossrefMedlineGoogle Scholar4. Maron BJ, Epstein SE, Roberts WC. Causes of sudden death in competitive athletes. J Am Coll Cardiol. 1986;7:204-14. [PMID: 3510233] CrossrefMedlineGoogle Scholar5. Mathews SC, Narotsky DL, Bernholt DL, Vogt M, Hsieh YH, Pronovost PJ, et al. Mortality among marathon runners in the United States, 2000-2009. Am J Sports Med. 2012;40:1495-500. [PMID: 22562789] doi:10.1177/0363546512444555 CrossrefMedlineGoogle Scholar6. Kim JH, Malhotra R, Chiampas G, d'Hemecourt P, Troyanos C, Cianca J, et al; Race Associated Cardiac Arrest Event Registry (RACER) Study Group. Cardiac arrest during long-distance running races. N Engl J Med. 2012;366:130-40. [PMID: 22236223] doi:10.1056/NEJMoa1106468 CrossrefMedlineGoogle Scholar7. Harris KM, Creswell LL, Haas TS, Thomas T, Tung M, Isaacson E, et al. Death and cardiac arrest in U.S. triathlon participants, 1985 to 2016. A case series. Ann Intern Med. 2017;167:529-35. doi:10.7326/M17-0847 LinkGoogle Scholar8. Vleck V, Millet GP, Alves FB. The impact of triathlon training and racing on athletes' general health. Sports Med. 2014;44:1659-92. [PMID: 25292108] doi:10.1007/s40279-014-0244-0 CrossrefMedlineGoogle Scholar9. Harris KM, Henry JT, Rohman E, Haas TS, Maron BJ. Sudden death during the triathlon. JAMA. 2010;303:1255-7. [PMID: 20371783] doi:10.1001/jama.2010.368 CrossrefMedlineGoogle Scholar10. Chase NL, Sui X, Blair SN. Swimming and all-cause mortality risk compared with running, walking, and sedentary habits in men. International Journal of Aquatic Research and Education. 2008;2:213-23. CrossrefGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Thomas Jefferson University Hospital and University of Pennsylvania; Philadelphia, Pennsylvania.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2031.Corresponding Author: Reginald T. Ho, MD, 925 Chestnut Street, Mezzanine Level, Philadelphia, PA 19107; e-mail, reginald.[email protected]edu.Current Author Addresses: Dr. Ho: 925 Chestnut Street, Mezzanine Level, Philadelphia, PA 19107.Dr. Glanz: 423 Guardian Drive, 801 Blockley Hall, Philadelphia, PA 19104.This article was published at Annals.org on 19 September 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDeath and Cardiac Arrest in U.S. Triathlon Participants, 1985 to 2016 Kevin M. Harris , Lawrence L. Creswell , Tammy S. Haas , Taylor Thomas , Monica Tung , Erin Isaacson , Ross F. Garberich , and Barry J. Maron Metrics Cited byIdentification of Swimmers in Distress Using Unmanned Aerial Vehicles: Experience at the Mont-Tremblant IRONMAN Triathlon 17 October 2017Volume 167, Issue 8Page: 589-590KeywordsCardiovascular diseasesExerciseHeartProspective studiesRacial and ethnic issuesRunningSportsSports and exercise medicineStable coronary artery diseaseSwimming ePublished: 19 September 2017 Issue Published: 17 October 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...