July 21, 2008
Autopsy Planned for Triathlon Death
The death of a participant during the eighth annual NYC Triathlon cast a pall over the event and raised questions about the conditions. Competitors mentioned that jellyfish were stinging them during the first leg--the 0.93 swim in the Hudson River. One described them as "the size of salad plates" to the Daily News. However, the NY Times, referring to WebMD.com, reported, "Jellyfish stings often result in minor allergic reactions; in rare cases, they can cause difficulty breathing, coma or death."
Fellow swimmers saw 32-year-old Esteban Neiva, from Buenos Aires, struggling in the water and called race officials for help. CPR was performed on him, but he was later pronounced dead at St. Luke's Roosevelt. An autopsy will be conducted tomorrow; this was the first death during the NYC Triathlon and the fourth during the swimming leg this year during a triathlon in the country.
Others mentioned the oppressive heat and humidity, but race director Bill Burke told the TImes, "Was the medical team taxed today? Of course they were. Athletes in this event push themselves, but athletes also have to understand that they need to be prudent and understand that on a day like this, they’re probably not going to get a personal record today." (Last October, a runner died during an unusually hot Chicago Marathon.)
Australians won the men's and women's races: Greg Bennet completed the race in 1:46:31 while Liz Blatchford won in 1:58:35.
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Massive physical exertion combined with a reasonably hot day for the race. Maybe it should have been called off due to the conditions?
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There continues to be an epidemic of sudden death among highly trained and conditioned athletes.
In addition to those listed above, an Olympic rower died last week during an non-race trial event.
These individuals have enlarged hearts as a result of their conditioning. When combined with unusual exertion and extremes of temperature and humidity, they become susceptible to lethal arrhythmias.
Some of those predisposed to arrhythmias can be detected by testing (stress testing, sonograms of the heart, etc.), but some are completely unavoidable.
Most athletes involved in extreme sports would choose to continue their participation, but they need to be informed of the risks involved.
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I would think that being in the water would make for far less oppressive conditions with regard to the heat. Also, it was very early in the race if this was a heat related death, wouldn't it have happened later during the run/bike and after he had time to overheat?
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Yes, but the term 'water' becomes suspect when applied to the rivers surrounding Manhattan.
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[3] I had the same thoughts. I suspect they're going to find it's some kind of pre-existing but asymptomatic medical condition. The headline seems a little redundant, though. I sure would hope they plan an autopsy. That's standard procedure when someone dies of unknown reasons.
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Famdoc, I'm assuming by your handle you may know as a professional, but it was my understanding that one cannot "enlarge" his heart from physical conditioning? You either have a larger than average heart from birth or you don't, i.e. Lance Armstrong. You can make your heart work better or more efficiently from physical training and exertion, but it doesn't get significantly "larger" as to cause possible health risk.
If I'm wrong, please clarify.
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rocknrope: I hate to resort to that fine medical source, Wikipedia, but they do have a good discussion of the athletic heart syndrome:
http://en.wikipedia.org/wiki/Athletic_heart_syndrome
Although usually thought of as benign, there are certain athletes who die suddenly and, on autopsy, are found to have an enlarged heart with few or no other abnormalities. It is usually concluded that these individuals had an episode of ventricular tachycardia that deteriorated into ventricular fibrillation and death. Occasionally, a congenital abnormality is detected: aberrant coronary artery anatomy, heart muscle disease (cardiomyopathy) or the like. Even rarer, a small blood clot (embolus) is found in one of the coronary arteries.
The important question is: can sudden death among athletes be avoided. Usually, the answer is no.
You would have to screen thousands of athletes to detect one at risk for sudden death. And, even then, you might find an athlete with no abnormalities who later dies during exercise.
It's a tough issue for doctors as well as athletes and very tragic when a young, healthy, productive person dies doing what he/she loves best.
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Agree w/ Famdoc. With 3,000+ athletes entering the event, a fatality is a statistical guarantee over time (this is the first event-related death for the NYC Triathlon). It's unfortunate, and it must be a terrible blow to the family, but it happens. The only reason why this is in the news is because (a) it's the NYC triathlon, a gruelling event, and (b) certain conditions, i.e. the heat and the jellyfish, make for good drama--remember, if it bleeds, it leads.
And re: [1] Refive, no it shouldn't have been called off. It's a tough event, and it was hot and humid, but definitely within acceptable norms. The race director almost certainly warned the athletes of the conditions and told them to adjust appropriately. I've raced in much tougher weather conditions (also, incidentally, with a jellyfish incident--in Raritan Bay, S.I. Also, gross used condoms floating by, but that's another story).
The best that can be said is that this guy (like the triathlete that died from a shark bite in San Diego earlier this year) died in a freak accident that no one could have prevented, and died doing what he loved. I suppose there are worst ways to go...
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Could have been a Mitral Valve prolapse.
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i was in the race and in the water that morning. It was the 5th time i did that race and never saw a jelly fish . But , trust me, maybe some people didnt get it that bad, a lot of people did. i was stung at least ten times, and one surrounded my whole face and got me good. the pain was intense and lasted about an hour. But i finished the whole race. IF nextyear they are out there I and many people would not go in the water. The race director was quoted as knowing there was a problem but did not think it was important to tell anyone over the PA. Bad decision. He should have at least warned everyone. Many people could have had known allergies. The athlete who died, could have easily went into shock or something after getting stung.