Today, the “Shenyang Marathon” race went smoothly. I guess your circle of friends is full of happy photos of runners. Nowadays, “marathon” has become a popular sport, and more and more young people are proud of running “half-marathon” or even “full-marathon”. “Marathon” has become a very fashionable program among white-collar groups. Every marathon, there are many people competing for a place in the race, which is very lively. However, with more and more reports of sudden deaths and injuries in marathons, we have a new understanding of the sport. Are you really fit to run a marathon? According to foreign authoritative statistics, the mortality rate of international marathon races in two out of 50,000, so the marathon and racing, judo, skiing, wrestling and other sports, are regarded as high-risk sports. Almost every one or two marathon races there is a sudden death reported. The number of injuries to the locomotor system is even in the thousands. The majority of sudden marathon deaths are due to heart attacks, while heat stroke and low blood sodium due to drinking too much water may also be the cause of death. Marathon, as a kind of long-distance strenuous aerobic exercise, requires very high endurance and cardiorespiratory capacity of runners. But the heart is not a perpetual motion machine, in our feeling of physical exhaustion, may be the heart’s pumping blood can not meet the body’s needs, may no longer regular heartbeat, may be …… these signs of cardiac anomalies may trigger the runner “sudden death”. Modern medicine divides sudden death into two categories: “sudden cardiac death” and “sudden cerebral death”, the former accounts for 75% of all sudden deaths, due to cardiac arrest and lead to the death of the patient in a short period of time. Sudden death due to cardiopulmonary problems, the pathogenesis may be: the human body in the intense intense exercise, the body’s metabolic rate accelerated, myocardial oxygen demand increased, this time easy to myocardial ischemia and hypoxia, ischemia, if more than half an hour, myocardial ischemic necrosis may occur, leading directly to cardiac arrest, which causes sudden death of the athlete. If it is a marathon, the risk of cardiovascular disease will increase seven times. Recent scientific studies have pointed out that by studying healthy older athletes who have run more than 100 marathons, they found that more than half of the runners had some degree of scarring of the heart muscle. And through lab mice, scientists have confirmed that long-term aerobic exercise may damage the heart. This damage to the heart is irreversible, meaning it cannot be recovered. The best health regimen should be a combination of multiple short bursts of high-intensity exercise, not just long-distance running such as marathons. Participating in long-distance running, as well as races such as marathons, requires a clear understanding of one’s physical condition, and it is best to have a thorough physical examination, especially a heart examination, before running a marathon for the first time. For heart examination, the current medical measures have been relatively perfect, the more commonly used clinical examination methods are: routine electrocardiogram, dynamic electrocardiogram (Holter), exercise plate electrocardiogram, echocardiography, CT, myocardial enzyme examination (blood test), coronary arteriography (coronary artery disease diagnosis of the “gold standard”), which are 7 kinds of examination. Arrhythmia is the most common type of arrhythmia. Arrhythmia is the most common heart disease, and the gold standard for detecting arrhythmia is the electrocardiogram (ECG). However, arrhythmic events, including episodic and paroxysmal atrial fibrillation, tend to be “transitory and insidious”, and may not be detected by the ECG at rest or for a short period of time, but they do exist. Especially for marathon runners, during strenuous exercise, the heart is more prone to problems than usual, so for these “hidden” arrhythmic diseases, we must carry out long-term monitoring and screening to determine whether our heart is really healthy, and whether we are really suitable to participate in marathon such as high demands on cardiorespiratory fitness. We need to monitor and screen our hearts over a long period of time to determine if our hearts are really healthy and if we are really fit to participate in sports like marathon which requires high cardiorespiratory fitness.