Twist of Fate of a Modern Day Pheidippides - Young Marathon Runner with Acute Right Coronary Artery Thrombosis

The occurrence of coronary artery disease is rare in young and physically fit individual. Regular exercise reduced incidences of coronary atherosclerotic disease. However, there are reported cases of myocardial infarction and sudden death after heavy and prolonged exercise. We describe an apparent healthy young male marathon runner presented with acute myocardial infarction shortly after completion of the run. Coronary angiography revealed occlusive thrombus in the distal right coronary artery and thromboaspiration was performed. Repeated angiography showed complete resolution of thrombus. The relationship between physical activity and acute coronary thrombosis remain elusive.