Key result
Extensive cardiac evaluation of an elite ultra-marathon runner who experienced acute chest pain during a 48-hour race revealed only a non-significant systolic dynamic narrowing due to a muscle bridge, and he successfully returned to extreme endurance sports.
Why the study?
Ultra-marathon running has grown in popularity, but cardiac evaluations explaining drop-out due to acute cardiac problems during extreme events require investigation.
Case Report (n=1)
Acute chest pain in an elite ultra-marathon runner was attributed to a myocardial bridge and moderate coronary calcium, which did not preclude a successful return to extreme endurance sports.
Acute cardiac events may occur even in experienced ultra-marathon runners; this case leaves open questions on risk stratification and monitoring.
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 2max ) 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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Sadowska‐Krępa et al. (2020) conducted a case report in Acute chest pain during ultra-marathon running (n=1). 48-h ultra-marathon race was evaluated on Cardiac evaluation for acute chest pain. Extensive cardiac evaluation of an elite ultra-marathon runner who experienced acute chest pain during a 48-hour race revealed only a non-significant systolic dynamic narrowing due to a muscle bridge, and he successfully returned to extreme endurance sports.
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