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Anyone else thinks hyperatheletism may not be in our best interest such as Marathons/triathlon? Shared with full permission. Young triathlete doc, syncope w DOE for a year, normal stress echo a year ago. Multiple TMT since 2010 (20METs) for family ho CAD not premature. Thread:
High risk hypoattenuated midLAD plaque so DOE is angina. Agressive medical therapy with very close follow up was opted. Major improvement in symptoms. Previously underwent CT angiogram PE protocol etc in ER visits for the same. Would you restrict actively at this stage?
Could he have benefitted more with CCTA rather than stress test a year ago? Multiple TMT since 2010 and always got best shape ever, nothing to worry. Have been on statin for FH. @khurramn1 @Heart_SCCT
Develops sudden worsening of DOE despite meds therefore did the coronary angiogram, went with guide directly as we knew what was under the table. Subtotal midLAD now! Really rapid progression since CCTA few months ago. Troponin would have been probably positive when change sympt
High risk plaque waiting to cause ACS (Or already did, just minor one?)
There was news about a young patient who had normal recent stress echo had similar DOE died while jogging. Couldn't be similar pathophysiology?
There was news about a young patient who had normal recent stress echo had similar DOE died while jogging. Couldn't be similar pathophysiology?
#imagefirst #radialfirst #samedaydischarge. CCTA plaque extended from 1st septals to 2nd, confimed by coregitration IVUS 3.0X20 PD 3.5. #accfit learning points:
1. Dont ignore symptoms even if normal stress test esp if sudden worsening
2. #YesCCTA gives more info than stress test
1. Dont ignore symptoms even if normal stress test esp if sudden worsening
2. #YesCCTA gives more info than stress test
Marathon running causes frequent rise in troponin: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1540-8183.2010.00575.x
