Symptomatic Coronary Artery Disease in a Marathon Runner

Abstract

To the Editor.— I was most intrigued by the article entitled Symptomatic Coronary Artery Disease in a Marathon Runner. Although the patient involved had maintained a Herculean exercise schedule for the past eight years, we must remember that this is a 48-year-old man who only did this for less than one fourth of his life. It is well known that even 20-year-old men can already have serious—if not life-threatening—coronary occlusion, and if this article was written to discuss the apparent inability of serious long-distance running to prevent coronary artery disease, then there are some unanswered questions that I would like to bring up. 1. Does intense marathon-type running later in life reverse any damage at all that was incurred earlier in life? 2. What is the effect of lifetime dietary habits? 3. What do competitive sports really mean? Although the patient had a relatively low cholesterol level and a relatively