What Runners Need to Know About Their Heart

Sometimes I feel like a broken record, but every year I like to tell my story. To build awareness in our running community. I like to remind my friends, patients and anyone that will listen that just because we run and live healthy lives doesn't mean we are invincible.

Ten years ago, I was running regularly. Training hard. Lifting. Eating right. Living what looked like a “healthy” runner’s life. And I almost died.

Not from a car.

Not from dehydration or heat stroke.

From my heart.

I have a rare genetic condition called ARVC/ACM, a type of cardiomyopathy where your heart muscle gets replaced with scar and fat. You can’t see it. You can’t feel it sometimes until it’s too late.

I had warning signs for years.

-Dizziness during runs.

-Heart palpitations at rest.

-Full-body exhaustion that didn’t match my training.

-I even passed out during a few marathons (BIG RED FLAG)

Each time, I got checked. And each time, I was told I was fine. Cleared to keep running.

I was not fine.

The last sign for me was a near-death arrhythmia while running. That experience completely changed the way I see endurance, health, and what we ignore in the name of “fitness.”

So no, this post isn’t about fear. It’s about awareness. Because if you run, even casually, even for fun, there are signs worth paying attention to. I’m not here to scare you. But I am here to make sure you’re not the person brushing off a heart issue because you “just need more electrolytes.”

Red Flags: When to Stop and Get Checked

These are not normal, even if they happen once. Even if you’re fit. If you check any of these boxes, stop running and get evaluated by a sports cardiologist (not just your PCP).

• You’ve passed out during or right after exercise

• You get chest tightness or pressure when you run

• Your heart skips, flutters, or pounds unexpectedly especially with exercise

• You’ve had seizures or blackouts with no clear explanation

• You have a family history of sudden cardiac death under age 50

• You have a known family history of cardiomyopathy or genetic heart disease

  
  

Don’t try to “train through” these. Don’t wait until after your next race. Don’t assume it’s your nutrition or sleep. Don't ignore them because you don't want to be told not to run. Your heart matters more than your splits.

Yellow Flags: Still Important

These symptoms can sneak up quietly. They’re easier to brush off, but if they stick around or feel new, you need to pay attention:

• New or unexplained fatigue with exercise

• Noticing that things (splits, workouts etc) that used to feel easy don't

• Racing heart at rest or during easy efforts

• Shortness of breath that doesn’t match your pace

• Sudden drop in performance with no musculoskeletal cause

• Heart flutters or skipped beats, especially post-run

  
  

One of the first signs for me was feeling like I was running through concrete, for weeks, with no reason. My legs were fine. My training was fine. My heart was trying to warn me.

What the Heck is ARVC?

First, I want to reiterate that it is RARE. I am not trying to scare you. Arrhythmogenic right ventricular cardiomyopathy / Arrythmogenic Cardiomyopathy (ARVC/ACM) is a genetic heart disease where the little bridges between cells break causing scar tissue for form. It affects how your heart beats and pumps and it can seemingly show up out of nowhere. ARVC/ACM is a leading cause of sudden cardiac death in young athletes, especially endurance athletes.

Here’s the bummer: high volumes of endurance training might make it worse. Which means the sport you love could be accelerating the damage if you don’t know it’s there. It was for me.

This is why I’ll say it again: if something feels off, get evaluated. And not just by anyone. You want a sports cardiologist who understands the difference between an athletic heart and a pathological one.

So, When Should You Actually See Someone?

• If you’ve had any of the red flags above

• If you’ve got a family history of sudden death, even if you feel fine

• If you’ve got yellow flags that don’t go away

• Or if you just feel like something’s off, its always better to double check than brush it off

  
  

We spend a lot of time learning about running gait, VO2 max, strength programming, nutrition, and recovery. But if your heart isn’t working right, none of that matters.

I wasn’t a pro runner. I wasn’t training for the Olympics. I was a solid endurance athlete who trained hard and took care of myself and I almost died because I didn’t know this was even a possibility.

I want you to run for years. To enjoy it. To stay strong and healthy. I imagined myself crossing the finish line at ninety years old. But you can’t ignore your body’s signals especially when it’s your heart trying to talk to you.

Pay attention. Don’t brush it off. And if this sounds like someone you know? Send it to them.

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