Mr Wilson collapsed a couple of miles from the finishing line

Reuben Wilson, 28, a company director from Leeds, was the youngest of four competitors to die during the Great North Run on Tyneside in September.

The inquest, sitting at Gateshead Civic Centre, heard that a team of medics struggled to resuscitate him.

But an ambulance with vital equipment took 45 minutes to reach the scene.

Deputy head teacher Phil Lewis, 52, from Chester-le-Street, County Durham, 43-year-old civil engineer David Mahaffey, from York, and businessman Kieran Patching, 34, from Walderslade, near Chatham in Kent, also died.

'Sirens blaring'

Mr Wilson was just a couple of miles from the finishing line of the famous half-marathon from Newcastle to South Shields when he suffered a heart attack and collapsed.

Martin Huitson said that his Red Cross rapid response car, even with sirens blaring, had problems getting through the crowds.

Some people were trying to flag down the vehicle to assist other runners.

Mr Huitson added: "We had our sirens going but because runners are naturally tired, and some wear earphones, it was quite difficult to get them to move out of the way."

An emergency ambulance also reported problems getting through the crowds.

Terrence Carney, the Gateshead and South Tyneside Coroner, also heard from pathologist Jennifer Hamilton who carried out post-mortem examinations on the four men.

Physically fit

She said tests had shown no evidence of drugs or alcohol in any of the men and none was suffering from dehydration.

There was no evidence of heart disease in either Mr Wilson or Mr Mahaffey and the most likely causes of their deaths was that their hearts suddenly stopped, which was most likely caused by an abnormality of cardiac rhythm.

Mr Lewis had died from heart disease, which was quite advanced for someone of his age, and Mr Patching was also suffering from heart disease but in addition had an abnormally large heart.

Because they were both very physically fit, neither would have suffered from any visible symptoms.

The hearing continues.