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Electrocardiogram (ECG) changes and cardiac biomarker abnormalities among two marathon runners
Alicia B Minns1, Richard F Clark
1Department of Emergency Medicine, University of California, San Diego, San Diego, California 92103-8819, USA.
The Journal of Emergency Medicine
|December 17, 2008
Summary
Extreme endurance exercise like marathon running can cause cardiac stress and myocyte injury, even in healthy individuals. Abnormal electrocardiograms (ECGs) after marathons may not indicate underlying heart disease.
Area of Science:
- Cardiology
- Sports Medicine
- Exercise Physiology
Background:
- Marathon running has gained significant popularity.
- A subset of marathon runners exhibit elevated myocardial-specific markers, sometimes indicative of acute myocardial infarction.
- Abnormal electrocardiogram (ECG) patterns have been observed in marathon runners.
Observation:
- This case report details two marathon runners who presented with similar, abnormal ECGs meeting acute myocardial infarction criteria.
- Both runners underwent cardiac biomarker analysis and coronary catheterization.
- One runner showed no coronary artery disease, while the other had severe left anterior descending artery occlusion.
Findings:
- Intense physical exertion, such as marathon running, can lead to myocardial stress and myocyte injury in previously asymptomatic individuals.
- Elevated cardiac biomarkers (troponin I) were observed in both runners, with significantly higher levels in the runner with coronary artery disease.
- Abnormal ECG patterns observed post-marathon did not consistently correlate with structural cardiovascular disease.
Implications:
- Physicians should consider extreme physical exertion as a potential cause for abnormal ECG findings and elevated cardiac biomarkers in runners.
- The findings suggest that ECG abnormalities in marathon runners may not always signify acute myocardial infarction or underlying coronary artery disease.
- Further research is needed to understand the relationship between intense exercise, cardiac biomarkers, ECG changes, and long-term cardiac health.
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