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by Peter A. McCullough, MD, MPH and Carl J. Lavie, MD

Many people believe that regular exercise is a good way to avoid blockages in the arteries to the heart and prevent heart attacks. A review article in the March/April 2014 Missouri Medicine: The Journal of the Missouri State Medical Association by cardiologists Peter McCullough, MD and Carl Lavie, MD point out that while exercise has many beneficial effects, it may be taken too far. In marathon runners, the chronic stress of endurance training for long periods of time may stiffen the heart arteries and allow them to become partially blocked. In addition, because the heart is pumping 5 to 8 times as much blood as during rest, marathon runners while training and racing hold this heavy strain on the heart for a very long time without rest breaks unlike other sports. When this happens, it may stretch the heart chambers and lead to scar formation in the cardiac muscle. Scar tissue in the heart is the cause of lethal heart rhythms and cardiac arrest in some of the highly publicized cases of seemingly healthy marathoners who die during long-distance running events. Future research is needed to find who is susceptible to having this happen, why, and how can we best train and exercise and enjoy the benefits without taking on life-threatening risks.

Published April 3, 2014

Peter A. McCullough, MD, MPH, is at the Baylor University Medical Center, Baylor Heart and Vascular Institute, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, TX, The Heart Hospital, Plano, Texas. Carl J. Lavie, MD, is Professor of Medicine, Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine & The Department of Preventive Cardiology, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana. 

Editor's note: This article is part of a special series brought to you by Missouri Medicine, the Journal of the Missouri State Medical Association (MSMA). MedHelp, Missouri Medicine, and MSMA are collaborating to educate and empower health consumers by making the latest scientific studies and medical research available to the public. Learn more about MSMA and see more from Missouri Medicine.

This is a summary of the article "Coronary Artery Plaque and Cardiotoxicity As a Result of Extreme Endurance Exercise," which was originally published in the March/April 2014 issue of Missiouri Medicine. The full article is available here.

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