Highlights the risk of sudden cardiac death from unrecognized hypertrophic cardiomyopathy during extreme exertion such as marathon running.
Undiagnosed HCM warrants caution with extreme exertion; single case leaves screening strategies open.
An experienced marathon runner died suddenly during a competitive race. At necropsy, ventricular hypertrophy but no asymmetrical septal hypertrophy was found. Histological studies showed features of hypertrophic cardiomyopathy. The coronary arteries were normal. We propose that the runner died from myocardial ischaemia, precipitated by marathon running on a background of hypertrophic cardiomyopathy. Excess cardiac work, induced by marathon running in the presence of mild congenital cardiac defects, could have contributed to the development of the cardiomyopathy.
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Noakes et al. (1979) studied this question.
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