A reader asks:

Can you explain why, in many big marathons, there is at least one runner who suffers a heart attack? I thought that running is supposed to be good for your heart.

I always feel awful when I read those news stories. Perhaps the greatest shock for me was when Ryan Shay, an extremely talented elite runner, collapsed and died during the Olympic Trials Marathon due to a heart condition.

However, keep in mind is that heart attacks during races are extraordinarily rare and that running has been shown to decrease the risk of having a heart attack. With that said, who is at risk for a marathon heart attack?

A recent article in the Arizona Republic lists three main reasons for the apparant rise of heart problems during races, including: 1) the number of participants marathons events has skyrocketed, which increases the risk that someone will have a heart issue, 2) the relative fitness of participants isn’t as good as it was years ago when almost all marathoners were experienced runners, and 3) there are more older runners participating in marathons.

I also add that some people simply have bad genetics. For example, Jim Fixx was one of the most popular authors of running books when he died of a heart attack during a marathon in 1984. Even though he ran lots of miles, Jim had multivessel coronary disease. This disease was caused by genes he had inherited from his parents, and, no matter how many miles he ran, nothing short of surgery was going to save him from a heart attack.

In closing, here are my thoughts about this issue: 1) If you train properly for a marathon you almost certainly have nothing to worry about, 2) If you have chest pains or other signs of heart trouble see a doctor and get cleared before you run a marathon.

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