Case Presentation: A 48-year-old healthy man suffered a complex ankle fracture in a cross-country skiing accident that required orthopedic surgery. In the hospital, a routine 12-lead ECG showed a 1-mm ST depression in lead V5 to V6, which prompted a noninvasive coronary artery calcium test that had a high score. Therefore, a coronary arteriogram was done, disclosing 70% to 90% lesions in 3 major coronary arteries, which were balloon dilated. Thereafter, the ankle surgery was performed successfully. The patient admitted that he felt assured that, as a physically active nonsmoker with a normal total cholesterol value on a routine test years earlier, no need existed for medical or cardiac consultation despite his strenuous recreational activity. In medicine, “screening” means to reach out actively to a certain segment of an apparently healthy population and recommend tests to detect the presence of a so-far undiagnosed disease at its earliest stage. This is in contrast to “preventing,” by which we mean advocating precautionary actions/tests/means to disclose factors that, if changed, may eventually prevent the disease. Widespread, intensive, and very important activities that seek to reduce ischemic heart disease (IHD) incidence, prevalence, and mortality through risk factor prevention, detection, and control are being carried out by cardiologists all over the world and are endorsed and encouraged by all official scientific bodies of cardiologists and physicians in general.1 The same, however, cannot be said about screening, which should/could take place after the established risk factors already initiate the process of the “cardiovascular continuum” that leads to tissue damage2 but not necessarily to symptoms. Although in other fields of medicine efforts to screen asymptomatic adults to detect various maladies are encouraged,3,4 in cardiology, even recent guidelines fail to deal explicitly with the approach to apparently healthy middle-aged nondiabetic persons and …