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Chest pain in an elite master ultra-marathon runner: a case report with a follow-up on his subsequent athletic activity


Sadowska-Krępa, Ewa; Kłapcińska, Barbara; Gerasimuk, Dagmara; Rzetecki, Adam; Waśkiewicz, Zbigniew; Gąsior, Zbigniew; Żebrowska, Aleksandra; Rosemann, Thomas; Nikolaidis, Pantelis; Knechtle, Beat (2020). Chest pain in an elite master ultra-marathon runner: a case report with a follow-up on his subsequent athletic activity. International Journal of Occupational Medicine and Environmental Health, 33(4):523-534.

Abstract

Ultra-marathon running has enjoyed increasing popularity, with the number of master ultra-marathon runners growing annually. This study presents a case of a 51-year-old highly experienced long-distance runner (body mass: 65.1 kg, body height: 168 cm), who took part in a 48-h ultra-marathon race held in 2010, but dropped out of the competition due to acute cardiac problems manifested after 16 h of running and having completed a distance of 129 km. Two weeks following the race, intense cardiac examination was performed to explain the drop-out due to chest pain. A 12‑lead electrocardiogram, a 2D transthoracic echocardiography in 3 apical projections of the left ventricle, a computed tomography of the chest, an invasive coronary angiography and a maximal oxygen uptake (VO<sub>2max</sub>) test were performed. The 12-lead ECG revealed a negative T wave in III and aVF without morphological abnormalities. The echocardiographic examinations presented a normal size and function of the heart chambers, and a normal valvar structure and function (only trivial mitral and tricuspid regurgitation was observed). The invasive coronary arteriography - due to an increased calcium score in the CT scan - showed only a non-significant systolic dynamic narrowing in the eighth segment of the left anterior descending artery due to a muscle bridge. The physical performance characteristics of the athlete and a follow-up history of his athletic activity showed that the cardiac problems he had experienced during the ultra-marathon race did not prevent him from being active in sport.

Abstract

Ultra-marathon running has enjoyed increasing popularity, with the number of master ultra-marathon runners growing annually. This study presents a case of a 51-year-old highly experienced long-distance runner (body mass: 65.1 kg, body height: 168 cm), who took part in a 48-h ultra-marathon race held in 2010, but dropped out of the competition due to acute cardiac problems manifested after 16 h of running and having completed a distance of 129 km. Two weeks following the race, intense cardiac examination was performed to explain the drop-out due to chest pain. A 12‑lead electrocardiogram, a 2D transthoracic echocardiography in 3 apical projections of the left ventricle, a computed tomography of the chest, an invasive coronary angiography and a maximal oxygen uptake (VO<sub>2max</sub>) test were performed. The 12-lead ECG revealed a negative T wave in III and aVF without morphological abnormalities. The echocardiographic examinations presented a normal size and function of the heart chambers, and a normal valvar structure and function (only trivial mitral and tricuspid regurgitation was observed). The invasive coronary arteriography - due to an increased calcium score in the CT scan - showed only a non-significant systolic dynamic narrowing in the eighth segment of the left anterior descending artery due to a muscle bridge. The physical performance characteristics of the athlete and a follow-up history of his athletic activity showed that the cardiac problems he had experienced during the ultra-marathon race did not prevent him from being active in sport.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of General Practice
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:16 June 2020
Deposited On:02 Jun 2020 15:45
Last Modified:19 Jun 2020 01:07
Publisher:Instytut Medycyny Pracy im. Jerzego Nofera
ISSN:1232-1087
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.13075/ijomeh.1896.01535
PubMed ID:32396147

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