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.

Jim Peters' collapse in the 1954 Vancouver Empire Games marathon.

On 7 August 1954, the world 42 km marathon record holder, Jim Peters, collapsed repeatedly during the final 385 metres of the British Empire and Commonwealth Games marathon held in Vancouver, Canada. It has been assumed that Peters collapsed from heatstroke because he ran too fast and did not drink during the race, which was held in windless, cloudless conditions with a dry-bulb temperature of 28 degrees C. Hospital records made available to us indicate that Peters might not have suffered from exertional heatstroke, which classically produces a rectal temperature > 42 degrees C, cerebral effects and, usually, a fatal outcome without vigorous active cooling.

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.