Two runners who died Sunday morning as participants in the Rock ’n’ Roll Marathon may fit the profile of the most common fatalities in such events, according to a Duke sports medicine specialist: men in their 30s with pre-existing, undiagnosed cardio abnormalities.
Saying the runners’ families wanted privacy, race organizers did not release the names of the men who died or give any indication of their causes of death.
“We regret to confirm that two participants passed away at today’s half-marathon,” said Dr. P.Z. Pearce, the event’s medical director. “We are greatly saddened by these tragic losses, and our prayers go out to the each of the runners’ family and friends.”
Wake County EMS and race medical personnel were immediately on the scene and attempted to revive each runner but were unsuccessful. The men were taking part in the 13.1-mile half-marathon.
Dr. Jeff Bytomski, head medical team physician at Duke University, said he had spoken with doctors at the event, “and they do think it’s cardiac, which is the most common reason” for runners to die at races.
“It’s just an inherent risk at these races,” he said. “It’s still a very low risk, but it happens.”
While the deaths are statistically uncommon, races in the Rock ’n’ Roll series have been marred by such tragedies at least 12 times since 2005, including the two in Raleigh on Sunday. Race officials identified the runners who died as men ages 31 and 35.
Weather should not have posed a concern for the race, medical officials said. Though temperatures reached the upper 70s in the afternoon, they were in the low 70s in the first hours of the event, when the deaths occurred.
The races are organized by Competitor Group Inc., described on its website as “a global media and event entertainment company dedicated to promoting the active lifestyle.” The races are held at venues all over the U.S. and beyond.
While runners’ deaths at races receive widespread attention, they are relatively rare. A study released in 2012 by the New England Journal of Medicine found that of almost 11 million registered participants in marathons and half-marathons between 2000 and mid-2011, there were 59 cardiac arrests, 42 of them fatal.
More than 85 percent of the cardiac arrests occurred in men. In the 23 deaths for which researchers could get detailed medical information, 15 were found to have an abnormal thickening of the heart muscle, and nine had additional cardiac abnormalities. Among those who survived cardiac arrest while running races, coronary artery disease was the most common problem, according to the study.
The events combine running with entertainment, with live bands playing music at every mile along the course and high school cheerleading squads providing motivation. Each race has a “finish-line festival,” with more music for runners and their supporters.
The events attract thousands of people.
About 12,500 were signed up to run in Sunday’s races, organizers said, and starts were staggered to prevent overcrowding. A Raleigh resident saw a runner fall near the finish line on Fayetteville Street.
“He would have made it”
Alex Granados, a columnist for the North Raleigh News, was on the sidelines along with thousands of other people to cheer for runners as they finished. He was waiting for his brother to complete the race.
“All of a sudden some people in line started calling for a medic. A guy had collapsed about a hundred yards down from me,” Granados said. “The paramedics came and spent 10 to 20 minutes furiously doing chest compressions. After a while, they got him on a gurney and wheeled him by me.
“It’s so sad because he was right near the finish line when he collapsed,” Granados said. “Two more minutes and he would have made it.”
Jeffrey Hammerstein, district chief with Wake County Emergency Medical Services, said race organizers had medical tents where workers tended to minor injuries such as blisters, cuts, and sore ankles, and could even handle some cases of heat exhaustion.
He said EMS was on hand with five ambulances and four paramedic bike teams to respond to more severe injuries or illnesses.
EMS saw a total of 31 patients at the race, Hammerstein said, and transported 10 of those to local hospitals. He said privacy rules prevented his saying what time the two runners who collapsed had died.
Last stretch can poses danger
During races, he said, medical problems usually rise toward the end of the half-marathon. In news reports of deaths at races, most are said to occur near the finish line.
Bytomski said that timing could be attributed to runners’ state by that point in the race, when runners have been exerting for a long time – an hour to three hours, depending on their speed. If they have had too little, or too much, to drink, they may suffer an electrolyte imbalance.
Even if they are regular runners, they may experience an adrenaline rush in the excitement of the race, and then get close to the finish line and decide to sprint in, he said.
Most of the runners who die in races probably have little warning, Bytomski said. They’re supposed to get checked out by a doctor before running a race, “But how many people do that?” he said.
So if they have a cardiac issue, they’re unaware of it.
“The sudden death is the first symptom,” he said. “It’s not like they’re coming in and saying they’re light-headed or having chest pain. They just collapse.”
According to race rules, runners were supposed to be in good health and “physically prepared to take on the challenge.” All runners signed liability waivers before setting off, said Rock ‘n’ Roll Marathon publicist Amana Miyamae.