The rarely heard "sudden death during exercise" was actually recorded more than 2,000 years ago

" Exercise-induced sudden death " refers to non-traumatic death that occurs within a short period of time ( generally within 6 hours ) with symptoms appearing during or after exercise . Many people think that those who die suddenly due to exercise are basically those who are weak and do not pay attention to exercise, but this is not the case.

Let me give you an example of the most famous case of sudden death during exercise in the world:

In 490 BC, the Athenians defeated the Persians in the Greco-Persian War and won the victory against the invasion. In order to let the people of his hometown know the good news of victory as soon as possible, the commander sent a soldier named Pheidippides to run back to report the victory. Pheidippides was a famous "speedster" in the army. After receiving the mission, he ran and ran without taking a breath. When he ran to Athens and excitedly shouted "Athens, we have won", he fell to the ground and died.

Yes, this is the origin of marathon running. Although this example is a bit extreme, we can also see that a well-trained soldier who is very good at running can die suddenly due to exercise, let alone ordinary people like us.

However, it is definitely not true to say that sudden death during exercise has nothing to do with physical condition. According to statistics, sudden death during exercise is mostly sudden cardiac death , accounting for about 70%. In other words, a large proportion of people who die suddenly during exercise have heart problems.

During exercise, the heart rate increases, the contractility of the heart increases, and myocardial oxygen consumption increases. Some people have potential insufficient blood supply to their hearts, which can aggravate myocardial ischemia, trigger myocardial infarction and malignant ventricular arrhythmias, and lead to sudden death; some people suffer from structural heart disease , such as hypertrophic obstructive cardiomyopathy and severe aortic valve stenosis. During exercise, the myocardial contractility increases, and structural reasons cause insufficient stroke volume, which can also cause sudden death.

So if after checking, there is no heart problem, is it safe? No. Non-cardiac sudden death, such as respiratory disease , cerebrovascular disease , idiopathic pulmonary hypertension , viral encephalitis , viral myocarditis , etc., can also cause exercise-induced sudden death.

There is also another special situation. In sports with obvious body impact, such as football, basketball, and rugby, the force generated by the sports impact on the heart happens to fall on the ventricular fibrillation zone , which can also trigger malignant ventricular arrhythmias and cause sudden death.

Don't think that you will be fine if you exercise regularly and are in good health. Every year, I hear about one or two cases of sudden death in marathons. To avoid similar tragedies, I have a few suggestions:

1. The organizer must have a good emergency plan. The organizers must have knowledge of cardiopulmonary resuscitation (CPR), the venue must have an automatic external defibrillator (AED) ready for deployment at any time, and first aid can be carried out within 4 minutes.

2. Get regular physical examinations, especially cardiovascular system examinations, to thoroughly check for potential disease threats, especially before participating in strenuous exercise or competition.

3. Ensure adequate warm-up.

Let as much blood as possible flow to the heart, lungs and muscles to ensure that after entering high-intensity exercise, the body's energy metabolism can meet the needs of exercise.

4. It is not recommended for untrained people to participate in high-load, high-intensity, and high-risk competitive sports.

5. Don’t push yourself. Don’t exercise if you have a cold or fever. If you experience obvious shortness of breath, chest tightness, or chest pain during exercise, you should immediately slow down or temporarily quit the exercise.

6. Don’t stop immediately after running. It’s best to walk for 10 to 20 minutes and take deep breaths to give your body some buffer time.

In short, we exercise to be healthier, not just for the sake of exercising.