Silent Myocardial Ischemia in Master Marathon Runners
Massimo Bolognesi *
Sports Cardiology Medicine Center, ASL 112, District of Cesena, Italy.
Diletta Bolognesi
Territorial Medicine Cesena, ASL 112, Italy.
*Author to whom correspondence should be addressed.
Abstract
Background: Silent myocardial ischemia is defined as objective documentation of myocardial ischemia in the absence of angina or anginal equivalents. There are a number of reports of exercise-related sudden deaths and myocardial infarctions in aerobically trained athletes suffering from exercise - induced silent myocardial ischemia. The most appropriate and used method to discover silent myocardial ischemia is the exercise stress testing.
Case Reports: In this article the authors describe three emblematic cases of silent myocardial ischemia detected in master marathon runners during systematic prepartecipation screening. These marathon runners were asymptomatic but suffering from a severe coronary artery disease that only thanks to exercise treadmill stress test was detected and properly treated.
Conclusions: Silent myocardial ischemia is not such a rare event in athletes, indeed quite the opposite. In fact, even though athletes are asymptomatic this does not exclude the possibility that they are suffering from severe coronary artery disease.
Keywords: Silent myocardial ischemia, exercise ECG stress testing; master athletes, coronary artery disease, sports pre-partecipation screening