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November 12, 1982

Myocardial Infarction in a National-Class Swimmer

JAMA. 1982;248(18):2313-2314. doi:10.1001/jama.1982.03330180073041

MYOCARDIAL infarction (MI) and sudden death are periodically reported in previously healthy young adults during strenuous exercise or athletic competition. The majority of these cases are explained by latent coronary atherosclerosis, anomalous coronary morphological conditions, or hypertrophic cardiomyopathy.1 However, exercise-related MI may also occur in young persons without apparent abnormalities of coronary or myocardial structure.2-4 A nontransmural MI occurred in a national-caliber swimmer during intense training. Subsequent cardiac catheterization and radionuclide angiographic studies disclosed patent coronary arteries and normal ventricular function.

Report of a Case  A 20-year-old man, who was a varsity swimmer, complained of severe substernal chest pain while performing a routine 15-km training session. The pain was unaffected by his position or breathing movements are gradually resolved after one hour of rest. He remained asymptomatic until 3 AM the following morning, when he was awakened by similar pain that prompted medical attention.He denied having a