Delayed enhancement of the intraventricular septum following an extraordinary endurance exercise

Paul S. Bhella, Jacob P. Kelly, Ronald M Peshock, Benjamin D Levine

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5 Scopus citations


Cardiac fatigue and elevations in cardiac biomarkers have been described following prolonged exertion in endurance athletes. We comprehensively evaluated a highly trained 46-year-old man attempting a North American transcontinental run in a record time of 45 consecutive days. After running 1460 km and ascending over 2600 m, the run was ended prematurely on day 17 following a leg injury; in support of the event, the subject cycled an additional 1580 km. Echocardiography and biomarker analysis performed pre-event and while running revealed no decrement in systolic function and undetectable levels of troponin I and T. Post-event cardiac MRI demonstrated the interval appearance of delayed enhancement of gadolinium at the inferior insertion of the right ventricle and in the interventricular septum - a novel finding that may represent subtle inflammation secondary to a combined exercise and altitude effect.

Original languageEnglish (US)
JournalBMJ Case Reports
Publication statusPublished - Dec 2 2010


ASJC Scopus subject areas

  • Medicine(all)

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