The incidence of exercise-associated hyponatraemia in the London marathon.

Background: Exercise-associated hyponatraemia (EAH) is a potentially fatal cause of collapse in endurance exercise. It is understood to be a dilutional hyponatraemia caused by an increase of total body water relative to the amount of exchangeable sodium stores. Fourteen runners presented to one London hospital with symptomatic EAH several hours after finishing the 2003 London Marathon, and more recently, a young male runner died from the complications of severe EAH after crossing the finish line of the London Marathon.

Marathon cardiac deaths : the london experience.

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.

Marathon medical support historical perspectives : 'from cradle to averting the grave'.

The history of marathon medical support is largely undocumented and anecdotal. Modern mass-participation marathon events attract thousands of variably trained and acclimatised participants to an event that is physically very demanding, in some cases covers difficult terrain, and may be held under stressful climatic conditions. Medical support for mass-participation events such as the marathon is directed at minimising the potential risks and avoiding the worst scenario where local medical emergency services and hospitals are flooded with casualties.

Exercise-associated hyponatraemia after a marathon: case series.

Objectives: To review the presentation, treatment and response of those runners from the London Marathon who presented to St Thomas' Hospital with exercise induced hyponatraemia.

Design: Observational case series.

Setting: St Thomas' Hospital, a tertiary hospital situated near the finish line of the 2003 London Marathon.