What happened to Pheidippides?

Legend has it that Pheidippides, a Greek messenger, ran 26 miles from Marathon to Athens to bring news of the Athenian victory over the invading Persians. Message communicated, he suddenly died from exhaustion.

Endurance sports such as marathon running put the heart under severe strain and volume overload for several hours. If the sportsperson has an undiagnosed or silent heart disease, this can be a deadly combination.

Cardiac conditions may affect both amateur and professional athletes, who are in seemingly fit shape.

Inherited cardiac conditions

A major complication of inherited cardiac conditions (ICC) is that they can lead to sudden death at a young age. This is because conditions are often missed or not managed appropriately.

This especially can happen when the individual is otherwise healthy, showed no symptoms, and the family history was not mapped and managed.

Diagnosis of inherited cardiac conditions can be difficult for a variety of reasons. Conditions can be complex in nature, have subtle features and be expressed variably.

With the Pheidippides intensive heart screening service at Guy’s and St Thomas’ Specialist Care, athletes can find out if they are at risk.


The Pheidippides intensive heart screening assessment is carried out over two half-days, starting late in the week as the heart is monitored over the weekend. The patient then returns early the next week.

  • at the first appointment, the assessment includes blood tests, cardiac MRI and an exercise test. The patient is then fitted with an ECG monitor which is worn over the weekend while exercising
  • at the second appointment, the patient is given an ECG test and an echocardiogram. Then, the consultant will discuss the results. Genetic screening for the patient or their family members may be recommended at an additional charge and supported by specialist clinical geneticists to provide counselling.

This service is offered by Guy’s and St Thomas’ Specialist Care to athletes referred for this level of testing.


The diagnosis for many cardiac conditions is based on a combination of markers from different diagnostic areas such as:

  • clinical and family history
  • genetic testing
  • electrocardiographic monitoring
  • cardiac imaging
  • histological and arrhythmic evidence

The most common diagnostic tests include:

  • ECG
  • echocardiogram
  • exercise test
  • angiogram
  • MRI scan
  • genetic testing, where appropriate

These tests are carefully interpreted to assess the risk for patients of having, or developing, a cardiac condition.


The cost of the Pheidippides intensive heart screening service is £4,500. Additional treatment and equipment costs may vary. Group rates are available upon request.

Patients can be self-funding, covered by private medical insurance or sponsored by their embassy.

Guy’s and St Thomas’ Specialist Care accepts referrals from general practitioners, as well as self-referrals.

Discover our team of cardiology specialists

The Pheidippides intensive heart screening service is currently available with Dr Antonis Pantazis, consultant cardiologist.