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9/17/11

The Most Dangerous Game: Dying to Win the Triathlon

The Most Dangerous Game: What is More Dangerous than a Marathon? A Triathlon. Swimming in Open Waters Riskiest Part of Triathlon


Video Depicting V Tachycardia

Could Over Exertion Caused BY Swimming in Open Water Cause V Tach? Ventricular Tachycardia





Athletes or weekend athletes who die in a triathlon generally have it happen in the swim section. Triathlon swimming is harder than just swimming in a pool. You are out in the open water with waves and turbulence. It can be cold and dark and you can be and probably are stressed out. The crowding and the other factors plus the difficulty of stopping in the open deep water ( that is without drowning) are likely explanations for why people have trouble in triathlons.

Why is the swim part of a triathlon so dangerous? Possible reasons why people in triathlons have more trouble in the swim section:
  1. Swimming in open water much harder than in a pool
  2. No where to stop immediately in the deep water
  3. cold and dark
  4. crowded
  5. Added stress may uncover heart defects
"An overwhelming majority of deaths in triathlons occur during the swim, where circumstances can conspire to create particularly stressful, even deadly conditions".

"According to a study of triathlons from 2006 to 2008 conducted by the American College of Cardiology, the risk of sudden death in a triathlon is about twice that of a marathon — 1.5 deaths per 100,000 triathlon participants compared with 0.8 deaths per 100,000 marathon participants".

In an article in JAMA about a medical study that looked at 950,000 people who partcipated on triathlons they said "Fourteen participants died during 14 triathlons (rate, 1.5 per 100 000 participants; 95% CI, 0.9-2.5), including 13 while swimming and 1 biking. Athletes who died were 28 to 65 years old (mean [SD] age, 44 [10] years). Triathlons with deaths included more participants (n = 1319; 95% CI, 1084-1584) than races without deaths (n = 318; 95% CI, 302-334). Of the swimming deaths, 11 were men and 2 were women.

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Six deaths occurred in short, 4 in intermediate, and 3 in long races (2 in an Ironman triathlon). Eight swimmers were in distress and called for assistance, and 5 were found motionless on the water. Deaths occurred in the open ocean (n = 6), lakes (n = 4), reservoirs (n = 2), or a river (n = 1). The bicycle fatality resulted from a fall causing cervical injuries.

Drowning was the declared cause of each swimming death, but 7 of 9 athletes with autopsy had cardiovascular abnormalities identified. Six had mild left ventricular hypertrophy with maximum wall thickness of 15 to 17 mm and mean (SD) heart weight of 403 (77) g, including 1 with a clinical history of Wolff-Parkinson-White syndrome. One other athlete had a congenital coronary arterial anomaly, and 2 had structurally normal hearts.


  • Sudden Death During Triathlon

    And then there is this from the NY Times: "A second competitor died Monday after apparently having had a heart attack during Sunday’s New York City Triathlon. "Two triathlon swimmers, a woman of 40 and a man of 64, were pulled from the Hudson river and subsequently passed away.

    “When you’re part of a community, it’s a tragedy when a member of your community passes,” said John Korff, the owner and organizer of the New York City Triathlon. “Our hearts go out to the families of these athletes.”

    "Korff and other triathlon officials said Monday that they would review procedures for the race, especially those pertaining to the swim leg, which precedes the cycling and running phases".

    "According to studies, those stresses can aggravate previously undetected heart abnormalities, leading to cardiac arrest. “So many things can go wrong in an open-water swim — it can add up to a perfect storm,” said Dr. Stuart Weiss, the triathlon’s medical director. “There’s some combination of water, adrenaline, pushing yourself hard, and all these things somehow work together to put people into an abnormal heart rhythm.” The deaths of Kudryk and Martich were the second and third in the 11-year history of the New York City Triathlon, after the 2008 death of Esteban Neira, a 32-year-old Argentine. Neira died in the Hudson from a condition linked to high blood pressure.Kudryk and Martich were among 28 people pulled from the water Sunday. There were 3,000 competitors in the triathlon, though some competed as part of relay teams and did not swim".

    “This is tragic and very, very sad,” said Bill Burke, the race director for the New York triathlon and several others around the country. “We will be working hard on the registration process and see if we can take it a step further.” "According to a study of triathlons from 2006 to 2008 conducted by the American College of Cardiology, the risk of sudden death in a triathlon is about twice that of a marathon — 1.5 deaths per 100,000 triathlon participants compared with 0.8 deaths per 100,000 marathon participants".

    "A 2010 study published in The Journal of the American Medical Association showed that of 14 deaths that occurred in triathlons between 2006 and 2008, 13 took place during the swimming portion. The study found that a majority of those who died had pre-existing heart abnormalities".

    “I don’t know where we are right now with triathlons,” said Dr. Kevin Harris of the Minneapolis Heart Institute, an author of both studies. “Marathons became safer over time as we learned how to identify people in trouble and got more defibrillators on the course, and as people learned more about how to train.”

  • Second Triathlon Swimmer Dies, Prompting Review of Race Protocol

    In an article about Athletes, Triathlons and Ventricular Tachycardia the author writes "Ventricular tachycardia can trigger skyrocketing heart rates, blackouts and even sudden death. While racing in the 2009 Ironman World Championship 70.3, the author, a former Ultraman and DecaIronman world champion, got a close-up look at “V-tach,” a condition that has put a halt to more than one world-class triathlon career".

  • Triathlon's Danger Sign Ventricular Tachycardia