Phidippides cardiomyopathy, a condition caused by chronic excessive endurance exercise.

In 490 BC, Phidippides, a young Greek messenger, ran 26.2 miles from Marathon to Athens delivering the news of the Greek victory over the Persians, and then he collapsed and died. This is probably the first recorded incident of sudden death of an athlete.

ScienceDaily Article LINK (June 4, 2012)

“ Micah True, legendary ultra-marathoner, died suddenly while on a routine 12-mile training run March 27, 2012. The mythic Caballo Blanco in the best-selling book, Born to Run, True would run as far as 100 miles in a day. On autopsy his heart was enlarged and scarred; he died of a lethal arrhythmia (irregularity of the heart rhythm). Although speculative, the pathologic changes in the heart of this 58 year-old veteran extreme endurance athlete may have been manifestations of "Phidippides cardiomyopathy,” a condition caused by chronic excessive endurance exercise.  “

See the rest of the article via the links provided.

More is not always better for some folks.

Get your heart checked yearly if you are an endurance athlete and watch for the signs you may have issues. Sadly the most consistent sign of Phidippides cardiomyopathy is sudden death.  So it is kinda hard to get ahead of the signs ! Be sure there is not a family history of Marfan’s type disorders that can affect the integrity of the artery walls amongst other things (clue: are you tall, skinny, long fingers and toes, abnormally formed sternum/protruding or sunken chest, loose jointed, loose skin, eye problems ?) If you have any of the following symptoms get checked out immediately:

  • chest pain
  • fainting
  • dizziness
  • chest palpitations
  • fatigue
  • shortness of breath (excessive or prolonged)

In closing we are going to paraphrase the Science Daily article one more time:

"Although it has been recognized that elite-level athletes commonly develop abnormal electrocardiograms and atrial and ventricular entropy, these adaptations traditionally have not been thought to predispose to serious arrhythmias or sudden cardiac death. However, it now appears that the cardiac remodeling induced by excessive exercise can lead to rhythm abnormalities. Endurance sports such as ultramarathon running or professional cycling have been associated with as much as a 5-fold increase in the prevalence of atrial fibrillation. Chronic excessive sustained exercise may also be associated with coronary artery calcification, diastolic dysfunction, and large-artery wall stiffening.”

It is important to remember, just because you are not having any symptoms or signs does not mean you are free of risk either.  Train wise, rest and recover and remember “everything in moderation”. When you know you are at an imbalance in your training, your risks may increase. And remember, this disorder takes years to develop so a clean slate exam now doesnt mean you are risk free forever.

RIP Micah. 

Shawn and Ivo……. not trying to scare anyone…….but an informed athlete is a smart runner and alive.