Marathoner's death due to hidden heart problems

SINGAPORE - His friends called him "man of steel".

Mr Malcolm Sng Wei Ren, 22, completed a gruelling half-marathon on Dec 4 last year.

It took him 1 hour 53 minutes to complete the 21.1km race in the Standard Chartered Marathon Singapore (SCMS) organised by the Singapore Sports Council (SSC).

But tragedy struck not long after Mr Sng crossed the finish line.

The first-year business administration student at Singapore Management University was spotted lying face down at around 9am.

He was unconscious when he was rushed to the Singapore General Hospital, and was pronounced dead at 9.30am.

A coroner's inquiry into his death revealed on Thursday that he had an "anomalous right coronary artery" which is an "infrequent congenital anomaly of the coronaries".

Dr Hsu Li Fern, a consultant cardiologist at Novena Heart Centre who is not involved in the case, told The New Paper this meant that Mr Sng's right artery came out in a different position from normal, taking a more tortuous route to supply the heart with blood.

He added that during physical exertion, the heart pumps hard and fast and this could cause the artery to kink, leading to a blockage.

The term "congenital abnormality" means he was born with this condition, said Dr Hsu.


The court heard that this heart condition could show no symptoms to those who have it. This condition may not be detected using normal health screening tests such as physical examinations and basic blood tests, the court heard.

But it may be detected by a procedure known as a coronary angiogram, a test that uses a dye and special X-rays to show the insides of one's coronary arteries. State Coroner Imran Abdul Hamid, who accepted the findings, said he hopes a similar death would not happen in the future.

He added that it is useful for people who want to take part in endurance events to go for check-ups and screenings.

Responding to queries from TNP, Mr Toh Boon Yi, SSC's chief of strategic development and marketing group, said that all participants in this year's SCMS will receive a Physical Activity Readiness Questionnaire (PAR-Q) and a heat disorder prevention guide in their race packs.

The PAR-Q is designed for individuals to find out more about their physical ability before engaging in any physical activities.

Mr Toh also recommends that those taking part in sport activities and those thinking of doing so, go through a pre-participation screening.

As in previous years, an event handbook is given to SCMS participants.

It contains a separate runner's checklist with seven questions for them to go through before race day.

Runners can use the checklist to gauge if they are feeling unwell and whether they have had sufficient rest the night before.

Mr Toh, who is also the deputy chairman of the organising committee of this year's SCMS, said: "If the checklist flags up something, runners should consider carefully and decide if they should really race."

But he stressed that each individual is ultimately responsible for their own safety.

"Runners taking part in the marathon should put themselves through a proper training programme in order to be conditioned for their race. We also recommend that first timers attend running clinics to gather advice on planning a training programme."

When TNP visited Mr Sng's flat in Sengkang, a woman, who identified herself as his mother, said she was still trying to cope with his death.

She declined to comment further.

What is a PAR-Q?

What is a PAR-Q?

The Physical Activity Readiness Questionnaire (PAR-Q) helps an individual to assess if he is fit for physical activity.

It has seven yes/no questions, including "Do you feel pain in your chest when you do physical activity?" and "Do you have a bone or joint problem?"

The Singapore Sports Council (SSC) stresses that the PAR-Q is a voluntary self-appraisal and not a medical check-up or clearance.

However, anyone who answers "yes" to any of the questions should stop the physical activity and consult a doctor.

The PAR-Q is designed for those aged 15 to 69 years old.

Said the SSC: "Caregivers should provide appropriate advice if you are below 15 years old. If you are above 69, you should consult your doctor and seek his advice and clearance before participating in any form of exercise and activity."

Marathon do's and don'ts

Marathon do's and don'ts

Running a marathon can turn deadly for some. The Straits Times previously reported that heart researchers in the US found that there are four to eight deaths in every million marathon participants.

Another study by researchers in Germany found that running activates both coagulation and platelet activity, resulting in an increased risk of runners having a blood vessel blocked by a blood clot.

Last month, in Philadelphia, US, two runners - one aged 21 and the other, 40 - collapsed at the finish line of the Philadelphia Marathon. They died of apparent heart attacks.

Doctors advise that preparation is vital.

This involves a proper training programme that includes resistance and flexibility training.

Runners must also wear the right shoes and must hydrate and refuel.

Those older than 35 or those with underlying risk factors - such as smokers, diabetics, and people with hypertension or with elevated cholesterol - should go for pre-participation screening. Don't run marathons if you:

  • Have not trained.
  • Experience chest pains/discomfort while doing light exercises.
  • Recently experienced a heart attack.
  • Are a hereditary or stroke-induced heart attack sufferer (especially if you pale when exercising).
  • Have high blood pressure and other heart diseases.
  • Are diabetic, obese or very elderly.

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