How to protect your heart: Cardiologist shares 3 tips to prevent fatigue during a marathon

How to protect your heart during marathons? Find tips on screening, fatigue prevention, and recovery strategies from a leading cardiologist.

Marathon running is not only a test of heart strength but also of the strength of the mind. Thousands of runners will be tested to the limit in challenging climatic conditions at the Tata Mumbai Marathon (TMM), scheduled for Sunday, January 18, 2026, in Mumbai. Although the physiological impact on the runner's heart and energy systems may be a strong motivator, a well-constructed strategy for safety and performance is necessary.

How to prevent fatigue and a heart attack while running? (Instagram)

By Tavishi Dogra

Tavishi Dogra is a Deputy Chief Content Producer, Health & Wellness, at Hindustan Times. She has over 9 years of experience writing about fitness, nutrition, and mental well-being, translating medical research and expert insights into practical advice readers can trust.

Career journey and experience
Tavishi began her health journalism journey in 2017, and has since reported for RSTV, Financial Express, Jagran, HT Media Labs and Zee. She joined Hindustan Times to simplify wellness subjects by cutting through jargon.

From decoding health trends and interviewing doctors to testing fitness routines herself, Tavishi always approaches content with one filter: “Will this help someone make a better decision today?”

Subject expertise
With 9+ years tracking India’s health conversations, Tavishi knows the gap between clinical advice and daily life. She knows fads from fundamentals and curates science-backed, expert-recommended solutions.

In fitness, she breaks down bodyweight training, recovery, and posture fixes for desk-bound readers. In nutrition, she translates guidelines into affordable, desi meal tweaks. In mental well-being, she focuses on stigma-free, actionable tools — all backed by research, expert input, and lived context.

Education and professional background
Tavishi holds a Master’s degree in Journalism and Mass Communication and began her career reporting on public affairs for broadcast. Those early years in policy and TV shaped how she writes today: fast, factual, and human-first.

Editorial Philosophy
I write with one single goal: To simplify health in a world full of noise by finding what’s actually doable, safe, and evidence-based for my readers. I test claims against research and user experiences. When all else fails, I speak to the expert who sees 50 patients a day, not the one with the most followers.

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How to protect your heart and prevent fatigue during a marathon?

To protect your heart and prevent fatigue during a marathon, consider these key tips:

Make cardiovascular safety a priority

At 42.2 kilometres, the heart endures significant stress. To protect it:

• Pre-race screening: "Runners and athletes in general, particularly those older than 35 years with a family history of heart disease, are to undergo an ECG and a stress test before starting any training cycle," says Dr Vijay D’silva, Cardiologist, White Lotus International Hospital, tells Health Shots. This helps detect underlying structural problems or arrhythmias that may be triggered by exertion.
• Awareness of cardiac drift in the human body: "When body temperature rises, the heart rate also increases, though the pace remains similar; measured heart rate zones, but not split times," says the cardiologist. If the heart rate enters the red zone prematurely, slow down to prevent overstraining.
• Viral recovery: Do not run a marathon or engage in intense training in the near future after a viral illness. "Post-viral myocarditis (inflammation of the heart muscle) is a cause of sudden cardiac events in endurance athletes," shares the expert.

2. Strategic fatigue prevention

The causes of fatigue in a marathon are most often either glycogen depletion (the wall) or electrolyte imbalance.

• Periodized fueling: It is just as important to train the gut as it is to train the legs. "Eating 30-60 grams of carbohydrates per hour will keep blood glucose at normal levels and prevent central nervous system fatigue," says the doctor.
• Precision hydration: Dehydration thickens the blood, increasing cardiac workload, whereas overhydration may lead to hyponatremia. Hydrate by drinking water and replenishing essential electrolytes (sodium, potassium, and magnesium).
• The 10% rule: Weekly increases in the mileage ratio must not exceed 10%. "This enables the heart and muscles to adjust and become stronger without falling into chronic fatigue," says Dr D’silva.

3. Recovery as protection

The heart is like any other muscle, requiring time to mend. Sleep and anti-inflammatory nutrition should be prioritised during post-race recovery. "A gradual reverse taper back to high-intensity training mustn't be done too soon, as this may lead to persistent fatigue and increased troponin levels, indicators of cardiac stress," says Dr D’silva. A responsible approach of pacing and listening to the body's intuition can help runners training for races achieve their personal bests without compromising their long-term cardiovascular health.

(Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.)