PDF(Pubmed)
Abstract：
UNASSIGNED: Marathon running poses unique cardiovascular challenges, sometimes leading to syncopal episodes. We present a case series of athletes who experienced pre-/syncope during the Zurich Marathon 2023, accompanied by elevated cardiac biomarkers.
UNASSIGNED: Eight athletes (2 females, 6 males) aged 21-35 years, with pre-/syncope and various additional diverse symptoms such as dizziness and palpitations during the (half-)marathon, were admitted to two emergency departments in Zurich, Switzerland. Clinical evaluations included electrocardiogram, echocardiography, telemetry, coronary computed tomography (CT) scans, and cardiac biomarker assessments. High-sensitive troponin T (hs-cTnT) was elevated in all cases at initial assessment and returned to normal at follow-up. All athletes who received CT scans had normal coronary and brain CT results. None of the eight athletes had underlying cardiovascular disease. Renal function normalized post-admission, and neurological symptoms resolved within hours. Creatinine levels indicated transient acute kidney injury. A common feature was inexperience in running, inadequate race preparation, particularly regarding fluid, electrolyte, and carbohydrate intake, along with pacing issues and lack of coping strategies with heat.
UNASSIGNED: From a clinician perspective, the case series highlights the challenge in the management of patients with a pre-/syncopal event during strenuous exercise and elevated cardiac biomarkers. Diverse initial symptoms prompted tailored investigations. Adequate training, medical assessments, and awareness of syncope triggers are essential for marathon participants. Caution and pacing strategies are crucial, especially among novices in competitive running. This information is pertinent given the growing popularity of marathon events and prompts a standardized diagnostic approach after these events.
UNASSIGNED: Eight athletes (2 females, 6 males) aged 21-35 years, with pre-/syncope and various additional diverse symptoms such as dizziness and palpitations during the (half-)marathon, were admitted to two emergency departments in Zurich, Switzerland. Clinical evaluations included electrocardiogram, echocardiography, telemetry, coronary computed tomography (CT) scans, and cardiac biomarker assessments. High-sensitive troponin T (hs-cTnT) was elevated in all cases at initial assessment and returned to normal at follow-up. All athletes who received CT scans had normal coronary and brain CT results. None of the eight athletes had underlying cardiovascular disease. Renal function normalized post-admission, and neurological symptoms resolved within hours. Creatinine levels indicated transient acute kidney injury. A common feature was inexperience in running, inadequate race preparation, particularly regarding fluid, electrolyte, and carbohydrate intake, along with pacing issues and lack of coping strategies with heat.
UNASSIGNED: From a clinician perspective, the case series highlights the challenge in the management of patients with a pre-/syncopal event during strenuous exercise and elevated cardiac biomarkers. Diverse initial symptoms prompted tailored investigations. Adequate training, medical assessments, and awareness of syncope triggers are essential for marathon participants. Caution and pacing strategies are crucial, especially among novices in competitive running. This information is pertinent given the growing popularity of marathon events and prompts a standardized diagnostic approach after these events.
摘要：
■马拉松跑步带来了独特的心血管挑战，有时会导致晕厥发作。我们介绍了一系列在苏黎世马拉松2023期间经历过晕厥前/晕厥的运动员，并伴有心脏生物标志物升高。
■八名运动员（两名女性，6名男性）21-35岁，伴有晕厥前/晕厥和各种其他不同的症状，如（半）马拉松期间的头晕和心悸，被送往苏黎世的两个急诊科,瑞士。临床评估包括心电图，超声心动图,遥测,冠状动脉计算机断层扫描(CT)扫描,和心脏生物标志物评估。初始评估时，所有病例的高敏肌钙蛋白T（hs-cTnT）均升高，随访时恢复正常。所有接受CT扫描的运动员的冠状动脉和脑部CT结果均正常。八名运动员中没有一名患有潜在的心血管疾病。入院后肾功能恢复正常，神经症状在数小时内消失.肌酐水平表明短暂性急性肾损伤。一个共同的特点是缺乏跑步经验，比赛准备不足,特别是关于流体，电解质,和碳水化合物的摄入，以及起搏问题和缺乏应对热量的策略。
■从临床医生的角度来看，该系列病例强调了在剧烈运动期间发生晕厥前/晕厥事件和心脏生物标志物升高的患者管理方面的挑战.不同的初始症状促使有针对性的调查。充分的训练,医学评估,和晕厥触发的意识是必不可少的马拉松参与者。谨慎和起搏策略至关重要，尤其是在竞技跑步的新手中。鉴于马拉松比赛的日益普及，此信息是相关的，并在这些比赛之后提出了标准化的诊断方法。
■八名运动员（两名女性，6名男性）21-35岁，伴有晕厥前/晕厥和各种其他不同的症状，如（半）马拉松期间的头晕和心悸，被送往苏黎世的两个急诊科,瑞士。临床评估包括心电图，超声心动图,遥测,冠状动脉计算机断层扫描(CT)扫描,和心脏生物标志物评估。初始评估时，所有病例的高敏肌钙蛋白T（hs-cTnT）均升高，随访时恢复正常。所有接受CT扫描的运动员的冠状动脉和脑部CT结果均正常。八名运动员中没有一名患有潜在的心血管疾病。入院后肾功能恢复正常，神经症状在数小时内消失.肌酐水平表明短暂性急性肾损伤。一个共同的特点是缺乏跑步经验，比赛准备不足,特别是关于流体，电解质,和碳水化合物的摄入，以及起搏问题和缺乏应对热量的策略。
■从临床医生的角度来看，该系列病例强调了在剧烈运动期间发生晕厥前/晕厥事件和心脏生物标志物升高的患者管理方面的挑战.不同的初始症状促使有针对性的调查。充分的训练,医学评估,和晕厥触发的意识是必不可少的马拉松参与者。谨慎和起搏策略至关重要，尤其是在竞技跑步的新手中。鉴于马拉松比赛的日益普及，此信息是相关的，并在这些比赛之后提出了标准化的诊断方法。
