Chest
Volume 108, Issue 1, July 1995, Pages 284-287
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Selected Reports
Onset During Exercise of Spontaneous Coronary Artery Dissection and Sudden Death: Occurrence in a Trained Athlete: Case Report and Review of Prior Cases

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This report describes a spontaneous coronary artery dissection occurring during exercise in a long-distance runner who otherwise had a normal coronary arteriogram. This syndrome has been reported before and the two previous cases are reviewed. Coronary dissection is a rare cause of death during exercise.

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Case Report

A 41-year-old male marathon runner was admitted to the hospital after cardiac arrest. He had no history of heart disease and was in excellent health. It was his practice to run 110 km/wk; he had raced in nine New York City marathons. He had no history of diabetes, hypertension, hyperlipidemia, or drug use. He had stopped smoking 6 years previously. He had no family history of coronary disease.

On the day of presentation, the patient and a friend were running when he experienced the sudden onset

Discussion

Spontaneous dissection of a coronary artery, in the absence of atherosclerotic coronary narrowing or dissection of the aorta, is a rare event that occurs predominantly in young women, often in the peripartum period. Coronary dissection is often fatal; the diagnosis is made at autopsy in 75% of cases.1

To our knowledge, we have reviewed all reported cases of coronary dissection reported in the English literature. Besides this case, exercise-related spontaneous coronary dissection with otherwise

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