Running is one of the best things you can do for your heart. Thirty to forty-five minutes of moderate activity a day lowers the risk of a cardiovascular event by about 30 %, and an estimated 80 % of cardiovascular diseases could be prevented through a healthier lifestyle. So why do we sometimes hear of runners collapsing?
These accidents do happen, and they deserve a straight conversation. In France, around 50,000 people die of cardiac arrest every year, more than 1,000 of them during physical activity (French Ministry of Health). That is rare relative to the number of people exercising, but it is real. The point is not to be afraid of running: it is to understand the risk, screen what needs screening, and know how to react. We cover all three, with the episode's guests: cardiologist Victor Waldmann, Protection Civile first responder Hugo Oumess, and Romane Courcault, who survived a cardiac arrest at 15.
Sport: friend or foe of the heart?
Friend, very clearly. Intense effort is not the cause of the accident: it is the revealer. It puts the heart under load, and if a weakness already exists, that is often when it shows. In fact, most of these accidents happen "in people who are usually inactive or sedentary, during unusual physical activity" (The Conversation).
The mechanisms differ with age. After 35, exercise-related cardiovascular accidents are due in 80 % of cases to atherothrombosis: cholesterol plaque, built up over years, breaks off and blocks an artery. In younger people, it is most often an undetected anomaly, genetic or congenital. And 70 % of sport-related arrests occur in a handful of disciplines, led by running, swimming and cycling (University of Burgundy Franche-Comté / The Conversation, 2023).
The signals to listen to, and what the heart does not always say
Some accidents, infarction in particular, are preceded by signs that should never be chalked up to fatigue. They can appear during exercise, but also within the hour that follows, during recovery.
Never brush these off
- Chest pain or tightness, sometimes radiating to the jaw or left arm, that resists usual painkillers.
- Abnormal breathlessness, out of proportion to the effort.
- Unexplained faintness or dizziness, during or just after exercise.
- Palpitations, and sometimes digestive symptoms. Note: signs often differ between women and men.
One honest point, stressed by the cardiologist: a cardiac arrest can also be sudden, with no warning sign at all, especially in a young person carrying an unknown anomaly. That is precisely why both sides matter so much: listening to the signals and knowing how to react when there were none.
Who should check in with a doctor
Not everyone needs the same level of screening. But some profiles should see a doctor before pushing hard: resuming after a long break, men over 35 and women over 45, family history, excess weight, smoking, cholesterol, and of course anyone who has felt one of the signs above. The golden rule from the Club des Cardiologues du Sport is simple: a medical check-up before resuming intense activity, and report any chest pain or abnormal breathlessness to your doctor, whatever your level.
Concretely: a consultation, an electrocardiogram, and depending on your profile a stress test. It is the cardiologist or sports physician who sets how often you should be checked. That is exactly the starting point of a serious progressive coaching plan, where load is increased without ever skipping steps.
The life-saving moves: the episode's real message
This is the most important and most actionable part. Without immediate care, nearly 93 % of cardiac arrests are fatal (French Federation of Cardiology). And without resuscitation, the chances of survival drop by about 10 % per minute: that is why you must act without waiting. Three reflexes, in order:
- Call emergency services (112 in Europe, 15 in France).
- Push hard and fast in the middle of the chest, 100 to 120 compressions per minute. The tempo? "Stayin' Alive" by the Bee Gees.
- Use the nearest defibrillator as soon as it arrives: there are 500,000 in France, and it guides you by voice.
Two tools worth knowing, mentioned in the episode. First-aid training with the Protection Civile (PSC, 7 hours): one day to be able to act for a lifetime. And the Staying Alive app, which brings together more than 540,000 citizen rescuers, locates the defibrillators around you and alerts volunteers near a victim. The fact that France sits at 7 % survival while Norway reaches 40 % comes down mostly to that: how many people are trained.
Running safely: the golden rules
The Club des Cardiologues du Sport sums up prevention in a few simple reflexes that cost nothing and protect a lot:
The good reflexes
- I report any chest pain or abnormal breathlessness on exertion to my doctor.
- No intense sport with a fever, nor in the 8 days following the flu (risk of myocarditis).
- Always warm up and cool down for about ten minutes.
- I hydrate: a few sips of water every 30 minutes.
- No intense effort below -5 °C, above +30 °C, or during a pollution peak.
- No tobacco or nicotine, especially in the 2 hours before and after sport.
- A medical check-up before resuming intense activity, especially after 35 (men) and 45 (women).
Sources: SAFE PACE episode "Cardiac arrest: every runner's dread" (with Victor Waldmann, cardiologist; Hugo Oumess, Protection Civile; Romane Courcault) · French Ministry of Health · French Federation of Cardiology · Club des Cardiologues du Sport · The Conversation / University of Burgundy Franche-Comté (2023).