Related, the ambulance system where I live has been running a clinical trail using a mobile ECMO unit (Extracorporeal membrane oxygenation) [1,2]. An invasive procedure that oxygenates and pumps blood. It's boosted survival rate for those who are not responding to CPR (15-20 minutes duration) from 3% to 28%. The general CPR survival rate is an exponential looking curve: starting around 20%, reducing to 10% at 10 minutes and 3% at 20 minutes [3].
I don't know if this is true, but my cardiologist said that everyone who trains hard for a marathon has some level of heart damage from the excessive training. This sounds extreme to me, but I was in to see him for some AFIB episodes that were triggered from pushing myself too hard. It's worth noting that endurance athletes are 2 to 10 times more likely to develop AFIB compared to non-athletes. So this is a bit of warning to apply some level of moderation to your training.
> my cardiologist said that everyone who trains hard for a marathon has some level of heart damage from the excessive training.
This strikes me as either your cardiologist being wrong or you misinterpreting what they said.
Can you damage your heart doing endurance events? Most certainly. I’ve seen at least two cardiac arrests during events where the person did not survive.
Does everyone who does an event suffer heart damage? No.
There have been quite a number of studies mentioned in ultramarathon journals that contradict your claim.
Additionally, I have run so many marathons and ultramarathons I’ve lost count. I just recently had my own extensive (and expensive, despite insurance) cardiology work where they observed no such damage. I asked them whether endurance sports cause heart damage, because I’m old and thinking of starting up again and the summary of their answer was “as long as you’re training properly, you’re good”.
That said, certainly these events put short term (~weeks/~months, depending) stress on the heart.
The article mentions new medical technology and techniques as increasing survivability but I also wonder if better training and awareness is also a key. When I started running ultras particularly, it was just a bunch of nutcases. But now you have “hobbyists” like soccer moms running them (and I’m thrilled about that) and doing well at them because there are sets of extremely good training knowledge out there.
Everything after about 60 minutes is overkill for health, and truth be told, probably 30 minutes of reasonably vigorous cardio is probably an ideal amount. I say this as a daily runner and someone who runs halves fairly regularly.
I find HN rife with its own form of "I'm too smart" bro-science.
Your cardiologist spoke directly with you; they're a trained, accredited, licensed, and in good standing professional. Go with your interpretation of what they told you.
Additionally, lets learn how to over-come HN's own form of bro-science because I'm pissed off right now.
Step 1: go to pubmed and throw the most basic of terms in: "marathon training cardiology damage"
Step 2: Quickly review the studies listed; we want to see studies after the advent of advanced hormone and mRNA quantification--that's around 2005 to 2010 or so--or anything within the last 5-10 years.
Step 3: Read through one study especially if it appears to be well setup or specific to what we are trying to understand--we can look at the abstract if we have some knowledge in the area, or are just getting a feel for the topic.
Step 3b: take note of terms; this study is an easy one and has everything we want to see in the abstract: https://pubmed.ncbi.nlm.nih.gov/36767963/ "Effects of Long-Term Endurance Exercise on Cardiac Morphology, Function, and Injury Indicators among Amateur Marathon Runners" in the Int J Environ Res Public Health
. 2023 Jan 31;20(3):2600. doi: 10.3390/ijerph20032600.
- left ventricular end-diastolic volume and left ventricular end-systolic volume indicator;
- myocardial injury indicators, serum levels of cardiac troponin I, creatine kinase (CK), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and N-terminal pro-b-type natriuretic peptide (NT-proBNP)
- Long-term high-intensity endurance exercise (not indicated; but "High intensity Steady State" (HISS) and similar will creep into our vocabulary)
Step 4: refine search to something like "cardiac morphology myocardial injury marathon amateur"; throw on "biological indicators", "creatine kinase"
Step 5: rinse, repeat, and read deeper into some of the studies.
Anyways, "Long-term high-intensity endurance exercise caused some damage to the hearts of amateur runners." and your cardiologist said the same. Or you can believe some rando giving medical advice on this forum. And honestly, I'm beyond irritated at the consistently bad takes on medicine, biomedicine, and exercise on YC HN.
As someone who enjoys distance running and has run some half marathons before, endurance running has some negative side effects (not as negative as no exercise at all, though).
You can feel this in extreme cardio endurance activities. After a certain point you can quite literally feel pain in your chest while being earstwhile healthy.
I - like ~20% of the humans of planet earth - have a bridged LAD coronary artery. The vast majority of those who have this congenital deformity will never know it and remain asymptomatic; a small cohort of those will, like me, have a minor heart attack and fully recover - a smaller cohort will die of sudden cardiac arrest, many of them males in their teens while practicing football or performing similar cardiac stressing events. Unfortunately determining this congenital deformity requires invasive radiological imaging - hopefully this technology will assist in it's identification sooner.
Distance running has, afaik, little to do with coronary artery disease (tho exercise can increase HDL some, it's only moderately protective and I recall that there are some studies that say that Marathon running actually is not healthful).
In my understanding of what happens during sudden arrest is that after having filled the artery wall tubing with as much plaque as it could stand, instead of ruptering through the outer wall , it collapses inwards, cutting off blood supply to the heart muscle.
Fun fact, there are two types of cardiovascular disease (CVDs), one being normal diseases and another is genetic.
Almost all of the deaths or mortality for young athletes (amateur or professional) are due to the genetic, for example mostly are based on the hypertrophic cardiomyopathy (HCM) [1].
Another fun fact, unlike normal CVDs, genetic based CVDs like HCM the death is totally preventable if it can be detected and treated early.
In many countries now CVDs screening including ECG is mandatory for professionsl atheletes, hopefully it can be made mandatory for amateur athelete as well e.g marathoners [2].
Interesting, I’d speculate that better hydration/hydration education and science play a part. While it used to be thought of as “part of the sport” it seems to be accepted that dehydration is really bad for you with no upside at all and to be completely avoided.
Yeah, it's been a while since anyone died during a marathon I was doing. Back when I started in the early 90s it would be one every couple of years or so.
Can't read the actual study because it's behind a medical journal paywall. It looks like they speculate that improved CPR training and AED use has caused this.
My speculation would be that these mega running nerds all wear watches that track their heart rate 24/7 now. I suspect if something is wrong then you get an earlier detection rather than only discovering it on a race day.
When I see a headline like this I like to play a game. I try to guess an absurd correlation ("it's the fancy new shoes") and try to guess some sort of possible mode of action. ("Change in forces on legs causes a change in blood flow through the body")
My dad is a big marathon runner and he's specifically had heart function tests (The one on the treadmill with the mask) with his cardiologist to reduce this risk further.
[+] [-] femto|11 months ago|reply
[1] https://www.abc.net.au/news/2025-04-07/nsw-ambulance-ecmo-tr...
[2] https://www.nsw.gov.au/media-releases/mobile-cardiac-treatme...
[3] https://www.bmj.com/content/384/bmj-2023-076019
Edit: The numbers in [3] are optimistic, as they are for in-hospital CPR, not out-of-hospital CPR.
[+] [-] bearsnowstorm|11 months ago|reply
(There are similar programs around the world with different models of care, notably in Paris, Albuquerque, the Netherlands and Regensburg, Germany).
[+] [-] shepherdjerred|11 months ago|reply
https://www.imdb.com/title/tt31938062/
[+] [-] iancmceachern|11 months ago|reply
[+] [-] proee|11 months ago|reply
[+] [-] runjake|11 months ago|reply
This strikes me as either your cardiologist being wrong or you misinterpreting what they said.
Can you damage your heart doing endurance events? Most certainly. I’ve seen at least two cardiac arrests during events where the person did not survive.
Does everyone who does an event suffer heart damage? No.
There have been quite a number of studies mentioned in ultramarathon journals that contradict your claim.
Additionally, I have run so many marathons and ultramarathons I’ve lost count. I just recently had my own extensive (and expensive, despite insurance) cardiology work where they observed no such damage. I asked them whether endurance sports cause heart damage, because I’m old and thinking of starting up again and the summary of their answer was “as long as you’re training properly, you’re good”.
That said, certainly these events put short term (~weeks/~months, depending) stress on the heart.
The article mentions new medical technology and techniques as increasing survivability but I also wonder if better training and awareness is also a key. When I started running ultras particularly, it was just a bunch of nutcases. But now you have “hobbyists” like soccer moms running them (and I’m thrilled about that) and doing well at them because there are sets of extremely good training knowledge out there.
[+] [-] altcognito|11 months ago|reply
https://archive.nytimes.com/well.blogs.nytimes.com/2012/01/1...
[+] [-] skylanh|11 months ago|reply
Your cardiologist spoke directly with you; they're a trained, accredited, licensed, and in good standing professional. Go with your interpretation of what they told you.
Additionally, lets learn how to over-come HN's own form of bro-science because I'm pissed off right now.
Step 1: go to pubmed and throw the most basic of terms in: "marathon training cardiology damage"
Step 2: Quickly review the studies listed; we want to see studies after the advent of advanced hormone and mRNA quantification--that's around 2005 to 2010 or so--or anything within the last 5-10 years.
Step 3: Read through one study especially if it appears to be well setup or specific to what we are trying to understand--we can look at the abstract if we have some knowledge in the area, or are just getting a feel for the topic.
Step 3b: take note of terms; this study is an easy one and has everything we want to see in the abstract: https://pubmed.ncbi.nlm.nih.gov/36767963/ "Effects of Long-Term Endurance Exercise on Cardiac Morphology, Function, and Injury Indicators among Amateur Marathon Runners" in the Int J Environ Res Public Health . 2023 Jan 31;20(3):2600. doi: 10.3390/ijerph20032600.
Step 3c terms:
- cardiac morphology, function, injury indicators;
- left ventricular end-diastolic volume and left ventricular end-systolic volume indicator;
- myocardial injury indicators, serum levels of cardiac troponin I, creatine kinase (CK), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and N-terminal pro-b-type natriuretic peptide (NT-proBNP)
- Long-term high-intensity endurance exercise (not indicated; but "High intensity Steady State" (HISS) and similar will creep into our vocabulary)
Step 4: refine search to something like "cardiac morphology myocardial injury marathon amateur"; throw on "biological indicators", "creatine kinase"
Step 5: rinse, repeat, and read deeper into some of the studies.
Anyways, "Long-term high-intensity endurance exercise caused some damage to the hearts of amateur runners." and your cardiologist said the same. Or you can believe some rando giving medical advice on this forum. And honestly, I'm beyond irritated at the consistently bad takes on medicine, biomedicine, and exercise on YC HN.
[+] [-] asdfman123|11 months ago|reply
Sprinting, though, 3x/wk, is very good for you.
[+] [-] lumost|11 months ago|reply
[+] [-] unknown|11 months ago|reply
[deleted]
[+] [-] EncomLab|11 months ago|reply
[+] [-] dm03514|11 months ago|reply
I wonder the fitness levels of the people that experienced cardiac arrests. Like were these first time runners that signed up to run a marathon?
[+] [-] cj|11 months ago|reply
[+] [-] readthenotes1|11 months ago|reply
In my understanding of what happens during sudden arrest is that after having filled the artery wall tubing with as much plaque as it could stand, instead of ruptering through the outer wall , it collapses inwards, cutting off blood supply to the heart muscle.
[+] [-] teleforce|11 months ago|reply
Almost all of the deaths or mortality for young athletes (amateur or professional) are due to the genetic, for example mostly are based on the hypertrophic cardiomyopathy (HCM) [1].
Another fun fact, unlike normal CVDs, genetic based CVDs like HCM the death is totally preventable if it can be detected and treated early.
In many countries now CVDs screening including ECG is mandatory for professionsl atheletes, hopefully it can be made mandatory for amateur athelete as well e.g marathoners [2].
[1] Hypertrophic cardiomyopathy:
https://en.wikipedia.org/wiki/Hypertrophic_cardiomyopathy
[2] Periodical cardiovascular screening is mandatory for elite athletes:
https://pmc.ncbi.nlm.nih.gov/articles/PMC1896145/
[+] [-] Lucasoato|11 months ago|reply
[+] [-] bookofjoe|11 months ago|reply
[+] [-] _--__--__|11 months ago|reply
Here is the (paywalled) JAMA article, which as far as I can tell is not on Anna's Archive etc yet
[+] [-] riversflow|11 months ago|reply
[+] [-] jfengel|11 months ago|reply
[+] [-] elliotto|11 months ago|reply
My speculation would be that these mega running nerds all wear watches that track their heart rate 24/7 now. I suspect if something is wrong then you get an earlier detection rather than only discovering it on a race day.
[+] [-] whycome|11 months ago|reply
[+] [-] killingtime74|11 months ago|reply
[+] [-] forgetmunch|11 months ago|reply
[deleted]