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On the paradox of exercise: coronary atherosclerosis in an apparently healthy marathon runner
Stefan Möhlenkamp1, Dirk Böse, Amir Abbas Mahabadi
1West German Heart Center Essen, Clinic of Cardiology, University Clinic Duisburg-Essen, Essen, Germany. stefan.moehlenkamp@uk-essen.de
Background:
An asymptomatic and apparently healthy 64-year-old marathon runner underwent comprehensive cardiovascular risk assessment as part of a prospective study on calcified coronary plaque burden in master marathon runners. His profile suggested a low 10-year cardiovascular risk.
Investigations:
Conventional risk-factor assessment, coronary artery calcium quantification, bicycle stress test, echocardiography, coronary angiography, intravascular ultrasonography, including virtual histology, and intracoronary Doppler ultrasonography.
Diagnosis:
Severe coronary atherosclerosis of the left anterior descending, mid left circumflex, and left main arteries.
Management:
Stenting of the left anterior descending artery, CABG surgery, and intensive risk-factor modification. The patient was also advised against participating in future marathon competitions.
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