Wednesday, April 16, 2008

Update on Marathon Death

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active.

The Little Rock Marathon took place on March 2nd. We had a runner, Adam Nickel, collapse after finishing the race in 3:02:26. He was not known to have any medical problems. He finished 18th overall in the marathon.
Autopsy Provides Answers, but little solace
Autopsy results from the Arkansas Crime Lab, released Monday, indicate that Nickel had a vascular disease known as “multifocal small coronary artery fibromuscular dysplasia,” which means he had small heart arteries that restricted the flow of blood. The small arteries were near a critical part of the heart that regulates electrical impulses.
That, combined with abnormal electrolyte percentage levels that many distance runners experience, including raised potassium percentage levels, led to a significant heart arrhythmia that proved fatal.
Dr. Charles Kokes, the crime lab’s chief medical examiner, said an electrocardiogram could have detected Nickel’s condition, but a physical alone would not.
Many runners might have Nickel’s condition, not know it and still feel fine, Kokes said. In Nickel’s case, the fact that the affected arteries were so near nodes in the heart that control electrical impulses led to the fatal event.


Jeffrey said...

ok he could do a 3hr marathon with restricted coronary arteries. now that's admirable. many people with normal anatomy can't even reach that level.

rlbates said...

You are right about that Jeffrey. I think my arteries are normal, but I can't ever seem to get that speed. I'm just a plodder.

Jeffrey said...

yea, just makes one apprehensive of doing endurance events. perhaps at an near elite level. i think ill just plod along like you and dr val.

Vijay said...

This is the first instance that I've heard of FMD in the coronary arteries. A cursory literature search shows that FMD though more common in the renal & craniocervical arteries, can rarely affect other arteries like the coronaries, limb arteries and even the pulmonary arteries. One article in eMedicine says "in 26% of patients, disease is found in more than one arterial region." ( This guy may have been in the other 74%.

Interesting Ramona. Thanks for sharing.

Anonymous said...

FMD can also be found in the large coronary arteries, mine was found in the LAD (distal) after my heart attack (as well as 4 other non coronary arteries).