Marathon Running After Myocardial Infarction

Eight patients, who had an aerobic power (maximum oxygen consumption) initially predicted as 72% of normal, were trained to the point of participation in the Boston Marathon one to four years after a demonstrated myocardial infarction. Seven of the eight completed the race at an average speed of 5.4 mph, corresponding to 81% of their maximum oxygen consumption. Symptoms and signs, both immediately after the race and later, were remarkably few. However, a substantial (4 kg) weight loss was incurred, with attendant dangers of heat stress. There was evidence of increased membrane permeability and protein catabolism (elevated levels of blood urea, creatinine, and creatinine phosphokinase) to a total of some 50 gm. Resting serum uric acid levels were normal. Marathon running should not be undertaken as a routine endeavor in post-myocardial infarction rehabilitation. (JAMA229:1602-1605, 1974)