On the paradox of exercise: coronary atherosclerosis in an apparently healthy marathon runner.
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.
Möhlenkamp
Stefan
S
West German Heart Center Essen, Clinic of Cardiology, University Clinic Duisburg-Essen, Essen, Germany. stefan.moehlenkamp@uk-essen.de
Böse
Dirk
D
Mahabadi
Amir Abbas
AA
Heusch
Gerd
G
Erbel
Raimund
R
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