Any doctors on here? Mo Farah passed out at NYC Half - what could cause that? Or should I assume something sinister?

I'm a medical doctor (second year resident) in the Emergency Department. No expert by any means, but I'd like to think enough to contribute to this LR thread.

Madmandoc wrote:

Of course other common causes are pooling of blood in the legs after exertion or dehydration, but it was a cold day and I don't see too many elite athletes faint after a race. Their bodies are usually adapted to that situation.

wasn't Mo training in Kenya for a while?

The latest:

"Mo Farah has reported no ill effects from his collapse...

The double world and Olympic champion lost consciousness for three minutes just moments after finishing in second place in lower Manhattan but is now said to be in “good shape” and on course for several more weeks of high-altitude training before his marathon debut in his home city on April 13.

It is understood that the UK Athletics medical team have been in touch with Farah and his coach, Alberto Salazar, to offer assistance but have been informed that he has made a full recovery from the episode.

Privately, Farah’s camp blame the sub-zero temperatures in New York for his meltdown after he suffered a similar collapse in freezing conditions at the European Cross Country Championships in Dublin in 2009. The effect of the cold was exacerbated this time because he had flown to New York directly from Kenya, where he had been training for the past two months in temperatures reaching 30C."

http://www.telegraph.co.uk/sport/othersports/athletics/10704147/Mo-Farah-flies-to-Kenya-for-London-Marathon-tune-up-feeling-in-good-shape-despite-his-collapse-in-New-York.html

"Privately, Farah’s camp blame lack of lead in the pencil and physical exhaustion after meeting up in New York with his wife who he hadn't seen for three months"

"He is 30 and at his peak – but the cost is three months' isolation from his wife"

http://www.theguardian.com/sport/blog/2014/feb/02/mo-farah-kenya-altitude-training-london-marathon

+ Cardiac CT

i dunno. it al depends wrote:

Dude you forgot the CT neck. then we should also throw in a D-dimer, cardiac Echo to rule out second place finish induced takotsubo cardiomyopathy, tilt test, cardio consult, neuro consult, and it goes without saying if nothing comes back positive an admit to medicine for serial trops and an in house stress test ;)

Micro dosing detecting wrote:

This is one of the dangers of microdosing, you take it all through training and then you deplete your body of essential medicines for the big day and subsequent drug test. The body just doesn't know how to cope without the drugs.

I´m very surprised that it took so many posts before we got a retarded drug accusation.

In college my coach gave us an injection of adrenaline before major races and it worked incredibly well for 5k and 10k distances. After graduation I found that when running longer distances (half and full marathon) that same injection made me light headed and I passed out twice. I am not sure if it was a combination of the adrenaline and lack of hydration or something else.

i'm an interventional cardiologist and my area of interest is sports physiology. i've done lots of research and presentations regarding athletes and heart disease in the past and i run a lot in my little free time.

either mo farah over exerted himself, thus depleting himself of glucose and had essentially no stores left following the end of the race. combine that with dehydration and you have decreased blood flow and nutrition to the brain and you pass out.

BUT the likely scenario is that mo farah stopped running too abruptly following the end of the race. as we all know, athletes are generally very fit and have low resting heart rates. this is due to a concept called accentuated antagonism (look it up, too long to explain here). essentially athletes have a parasympathetic system that works in overdrive throughout the day. So while mo farah was running the race, his sympathetic system was working and all the major blood vessels in his body were dilated to augment blood flow. As soon as the race finished, he stopped running. At this moment his parasympathetic system kicks in immediately (keep in mind, this overactive parasympathetic system is why 'fit' athletes have a heart rate that very quickly returns to normal after exercise). This causes his heart rate to drop precipitously from lets say...180 BPM to about 90-100BPM in the matter of seconds. So not only do we have a drop in his heart rate, but his blood vessels are still dilated, which then causes his blood pressure to drop transiently, decreasing blood flow and oxygenation to the brain and then he passes out. as soon as he passes out, his vessels will quickly start to constrict back to normal and this allows adequate blood flow to the brain and he wakes up wondering what happened.

hope this helps.

orthostatic hypotension due to volume depletion a d probably mild hypothermia

probably orthostatic hypotension due to core volume depletion from mild dehydration and mild hypothermia

If he had orthostatic hypotension he would have passed out earlier during maximal exertion because the effect of decreased cardiac output would be even more profound

The hypotension occurs after the secession of exercise. As a result of it, in fact.

I seem to remember that the last time Mo collapsed in the European cross Country Championships it was later diagnosed as being due to low magnesium levels.

I'm not sure that he actually passed out on that occasion but he was certainly distressed. Any input from the medics on this thread as to if this could be a possible cause.

pre-med wrote:

This is a serious question.

So I see that Farah passed out after the NYC half today.

Any medical people have an idea as to what could cause that?

Or should I assume something sinister related to a PED?

I'm not throwing accusations but wondering what a medical doctor thought when they read he passed out.

I've heard of people passing out in heat but cold weather?

Sh!t fueling and/or sh!t use of glycogen over the course of an hour.

Bad signs for the marathon.

Sounds like orthostatic hypotension, no? Or an idiopathic result of it?