Silent Myocardial Ischemia in Master Marathon Runners

Background: Silent myocardial ischemia is defined as objective documentation of myocardial ischemia in the absence of angina or anginal equivalents. There are a number of reports of exercise-related sudden deaths and myocardial infarctions in aerobically trained athletes suffering from exercise - induced silent myocardial ischemia. The most appropriate and used method to discover silent myocardial ischemia is the exercise stress testing.
Case Reports: In this article the authors describe three emblematic cases of silent myocardial ischemia detected in master marathon runners during systematic prepartecipation screening. These marathon runners were asymptomatic but suffering from a severe coronary artery disease that only thanks to exercise treadmill stress test was detected and properly treated.
Conclusions: Silent myocardial ischemia is not such a rare event in athletes, indeed quite the opposite. In fact, even though athletes are asymptomatic this does not exclude the possibility that they are suffering from severe coronary artery disease.