The Incidence of Exercise-Associated Hyponatraemia in the London Marathon Courtney Kipps,1 Sanjay Sharma,2 Dan Tunstall Pedoe3
Downloaded from bjsm.bmj.com on March 28, 2013 - Published by group.bmj.com Original article The incidence of exercise-associated hyponatraemia in the London marathon Courtney Kipps,1 Sanjay Sharma,2 Dan Tunstall Pedoe3 1London Marathon and ABSTRACT to 24 h after prolonged physical activity.4 The Specialty Trainee in Sport and Background Exercise-associated hyponatraemia disorder is broadly classifi ed into symptomatic Exercise Medicine,Charing Cross Hospital and Queen (EAH) is a potentially fatal cause of collapse in or asymptomatic hyponatraemia by the presence Mary, University of London, endurance exercise. It is understood to be a dilutional or absence of signs or symptoms rather than by London, UK hyponatraemia caused by an increase of total body the absolute value of [Na+] as this is not a reli- 2London Marathon water relative to the amount of exchangeable sodium able predictor of clinical severity.4 Early signs and Consultant Cardiologist, stores. Fourteen runners presented to one London and symptoms of hyponatraemia are non-specifi c Kings College Hospital, London, UK hospital with symptomatic EAH several hours after such as bloating, nausea, vomiting and headache. 3London Marathon fi nishing the 2003 London Marathon, and more recently, The more severe manifestations of hyponatra- and Retired Consultant a young male runner died from the complications of emia, hyponatraemic encephalopathy caused by Cardiologist, Homerton severe EAH after crossing the fi nish line of the London cerebral oedema, can lead to confusion, seizures, Hospital, London, UK Marathon. coma and death.4 Correspondence to Objectives To determine the incidence of EAH in EAH is widely understood to be a dilutional Dr Courtney Kipps, runners in the London Marathon.
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