“Enduroman Events‏ ‪@EnduromanEvents Aug 7





We’ve put lights on #DougWaymark at 2000 on last feed. Sun is setting. Calais is lit up as we head down with the tide. Wind has dropped.

Enduroman Events‏ ‪@EnduromanEvents Aug 7

2030 water taken. Moon is rising behind a cloud over Calais. Air temp dropping, light fading. ‪#DougWaymark swims on. ‪#Arch2Arc

Enduroman Events‏ ‪@EnduromanEvents Aug 8




Our friend Douglas Waymark sadly passed away during his Solo Arch to Arc. Enduroman community miss him. Short tribute ‪http://www.enduroman.com”

 

It’s impossible not to be moved by this series of tweets.

Many of you will have read of the sad death of Doug Waymark this week, as he attempted to complete the Arch to Arc challenge. This is a run from Marble Arch in London to Dover (87 miles) followed by a swim across the channel (21 miles) followed by a cycle to Paris (180 miles). Only 25 people have completed it. The record is 59 hours and 56 minutes.

Doug got into trouble during the swim, 12 miles off the coast of Dover. He could not be resuscitated. He was an able athlete who had completed ultra-events before. It’s impossible to know at this stage exactly what happened.

Phidippides is said to have run from Marathon to Athens to deliver news of a military victory at the Battle of Marathon. On delivering the news he died suddenly. Death during exertion is mercifully rare, but always shocking. How can it be that someone who is fit and well can die so suddenly?

The most common cause of death during exercise in men over 40 is coronary artery disease – a blockage of one of the coronary arteries. These arteries supply your heart with blood. When one blocks, an area of the heart can’t function any more. If it is a branch of a small artery you may not notice. If it is one of the larger arteries you will typically die very rapidly. What people don’t understand is that an artery can go from open to blocked very quickly. And therefore, you can have no symptoms at the start of a race. As you get older you build up deposits of fat, covered over with a thin layer, in the arteries. This thin covering can rupture and then a clot can rapidly form, blocking the artery. Furthermore, because the human body is amazing, it is possible for the body to compensate for quite significant problems in the coronary arteries before symptoms arise.

An alternative (there are many) is that he could have torn one of the coronary arteries – coronary artery dissection – or the aorta itself. This can happen under periods of intense strain, although it is less common. Some people have coronary arteries that arise from slightly different locations (anomalous coronary arteries) and these seem to be the cause of sudden death during exercise in some people.

In younger people, hypertrophic cardiomyopathy seems to be the most common underlying condition which causes sudden death during exercise. This is a disorder of the heart muscle. Normally the heart muscles are laid down in neat sheets – the muscle cells are aligned. In hypertrophic cardiomyopathy (HCM) the muscle cells look like they have been scattered and the term used is disarray. People suffering from HCM are more prone to heart failure and heart rhythm problems.

There are other possibilities too – such as problems with the right ventricle (arrhythmogenic right ventricular cardiomyopathy) and problems with the electrical systems (Long QT syndrome, catecholaminergic polymorphic ventricular tachycardia – they all have obscure names). More on these in future articles.

But the reality is that death during sport is rare. About 1 in 1,000,000 young people die during exercise each year and about 6 per 100,000 middle aged people. And that is why Doug Waymark made the news.

More lives are saved by exercising than caused by it. But as with all things in life, nothing is completely safe. Reading the news suggests that Doug was someone who helped and inspired others to achieve their goals. He will have saved many lives, although tragically lost his own.

#BeMoreDoug

 

 

 

 

 

 

 

           

Written by mjd

A 40something cardiologist from the UK

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