title: On the paradox of exercise: coronary atherosclerosis in an apparently healthy marathon runner.
abstract: 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.
  
  
  METHODS
  Conventional risk-factor assessment, coronary artery calcium quantification, bicycle stress test, echocardiography, coronary angiography, intravascular ultrasonography, including virtual histology, and intracoronary Doppler ultrasonography.
  
  
  METHODS
  Severe coronary atherosclerosis of the left anterior descending, mid left circumflex, and left main arteries.
  
  
  RESULTS
  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.
authors.affiliation: West German Heart Center Essen, Clinic of Cardiology, University Clinic Duisburg-Essen, Essen, Germany. stefan.moehlenkamp@uk-essen.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Möhlenkamp
authors.forename: Dirk
authors.initials: D
authors.lastname: Böse
authors.forename: Amir Abbas
authors.initials: AA
authors.lastname: Mahabadi
authors.forename: Gerd
authors.initials: G
authors.lastname: Heusch
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
mesh_terms: D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy; D015444:Exercise / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000235:genetics; D012420:Running / Q000502:physiology*; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional