Steve collapsed to the ground unconscious, half a mile from the finish line of the Cardiff half marathon. A previously healthy 19-year-old, he recovered quickly and blamed the abrupt end to the race on dehydration, but was worried enough to see his GP who referred him urgently to my cardiology clinic. Following some basic investigations I realised that he should not have competed in the race. He has a heart muscle disease (cardiomyopathy) that puts him at high risk of sudden cardiac death (SCD), especially when participating in endurance sports.
SCD in the young is a tragic and shocking phenomenon, which kills around 12 people aged 35 and under every week in the UK. An estimated one in 300 of the general population has an underlying heart condition predisposing them to SCD. With more than ten million people in Europe taking part in endurance sports such as marathons and iron man competitions, it is inevitable that we will hear the news of another young and fit person dying while participating in one of these events. In the younger population, SCD occurs due to structural heart disease, cardiomyopathy, or electrical disturbances of the heart. In older people, the risk is mainly due to coronary artery disease (heart attacks). Up to 80 per cent of SCD occurs in people who were previously free of any symptoms.
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