The Athlete's Heart From Philippides to the Modern Marathon Runners

Silvia Castelletti; Guido E. Pieles


Eur Heart J. 2022;23(27):2538-2541. 

In This Article

Abstract and Introduction


There are in fact two things, science and opinion. The former begets knowledge, the latter ignorance.
Hippocrates, Paul Potter (1984). 'Hippocrates'

'Joy to you, we have won!' the last words pronounced by Philippides before the occurrence of the first sudden cardiac death (SCD) in sport. Legend has it that Philippides died after running ~40 km from Marathon to Athens to announce the victory of the Greek forces against the Persians. Further research demonstrated that Philippides had run actually almost 500 km, as he went from Marathon to Athens, from Athens to Sparta, and back to Athens. Indeed, despite this distance, he actually survived as his story was merged with that of another runner, Eucles, who 50 years later ran to Athens to announce victory and died. This first SCD of an athlete did not question the upheld benefits of sports and physical exercise in the classic world, where through the teachings of philosophers such as Plato (428–348 BC), in his Republic, but also the works of Herodicus (5th century BC) and his most famous pupil Hippocrates (460–370 BC), physical exercise became a core part of the education of the citizen in ancient Greece. This concept of benefits without significant harm was passed on through the works of Galen (129–210 AD) and handed down through the centuries relatively unexamined until the 1800s[1] (Figure 1).

Figure 1.

Historical milestones in the description of the athlete's heart. Free cliparts by