University of Pennsylvania student, Jeffery Lee, was one of two people who died during the running of the Philadelphia Marathon Sunday.
"My brother was a remarkable person," said Matt Lee. "He’d move heaven and earth if it meant being able to make someone’s pain go away."
The native Californian was a leader on UPenn's campus where he was set to graduate this spring with dual degrees from the Wharton School of Business and Nursing School.
"Jeffery was known as a campus leader and someone who made a positive impact on a ton of people and I think it's a very somber mood on campus," one student said.
It's hard for some Penn students to understand how a seemingly healthy 21-year-old young man could suddenly collapse and die at the finish line of the half-marathon course.
"Someone that young would have to have a problem. Usually it's related to a congenital abnormality," said Bryn Mawr Cardiologist, Dr. Francis Day.
The official cause of death for Lee was still unknown as of Monday night.
"I was at the medical examiner’s office today," said brother Matt. "They did an autopsy -- they couldn’t find anything wrong with him... So I'm just left asking why -- how did this happen, why did this happen?"
Dr. Day says a potential cause could be hypertropic cardiomyopathy, an abnormal thickening of the heart muscle. It's the No. 1 cause of sudden cardiac death in the United States.
"This is something that is difficult to screen for," said Dr. Day. "To do EKGs on everybody, to do echocardiograms on everybody is not a cost-effective way to deal with this."
Dr. Day, who has finished three marathons himself, says runners need to know their health history. Red flags would be episodes of fainting or a family history of sudden cardiac death. People with that kind of history need intense screening before considering a long run, according to Dr. Day.
Different concerns come into play for runners like the second victim, G. Chris Gleason of Clifton Park, N.Y. The 40-year-old collapsed about a quarter-mile from the full marathon finish line.
His official cause of death was also not determined as of Monday night.
"My guess is that he had an actual coronary event, an actual heart attack," Dr. Day said.
Gleason was a father of two who was an avid skier, snowboarder, triathlete and even three-time Ironman, according to his obituary.
An adrenalin rush can also contribute to heart problems during a race, according to Dr. Day. Lee and Gleason collapsed at or near the finish line. And drinking too much water can also harm the heart during a long race.
"People who are drinking water at every station actually are over-hydrating and their serum sodium comes down and they may be more susceptible to various maladies, especially as the race goes on."
Dr. Day says no one should attempt a marathon unprepared, meaning without special training in fitness and even nutrition.
Whatever the cause of deaths for both men, their families were left without their loved ones.
"(Jeffrey) sent (our mother) a text saying -- going to run the marathon, happy birthday mom, I love you," brother Matt said. "And then on his phone, the first thing he scheduled for after the marathon was to give mom a call."
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