Dr. Paul D. Thompson, MD, explains why he considers high coronary calcium in endurance athletes not benign, how he says these athletes should be treated, and whether they should keep exercising.
High Coronary Calcium in Endurance Athletes: Treatment and Continued Exercise
Jump To Section
- Why high calcium is not benign
- Treatment as for known coronary disease
- Exercise without a false sense of protection
- Full Transcript
Why high calcium is not benign
High coronary calcium in endurance athletes is not benign, Dr. Paul D. Thompson, MD, tells Dr. Anton Titov, MD. It was initially thought to be just calcification, he explains, but soft plaque is also present. Calcified plaque is thought to be pretty safe, while uncalcified or partially calcified plaque can rupture and lead to a heart attack and sudden cardiac death.
Treatment as for known coronary disease
Aggressive lipid reduction is the treatment Dr. Thompson recommends, just as for anyone with known coronary disease. In his view, these athletes face the same heart attacks, bypass surgery and angioplasty as patients who do not exercise. He adds that athletes live longer for their coronary calcification, as he puts it, so being an athlete is a good thing.
Exercise without a false sense of protection
Stopping exercise is not necessary, Dr. Thompson says, but athletes should pay attention to themselves and drop the idea that exercise is a protective bulletproof vest. Athletes with high coronary calcification can have heart attacks, strokes and other problems, and he says they need aggressive treatment to bring their cholesterol down.
Full Transcript
Dr. Anton Titov, MD: Coronary calcium in athletes, high coronary calcium in a very active person. In an editorial you asked whether coronary calcium means the same in active and sedentary people. On your blog you wrote that high coronary calcium in a very active person is not benign. You chaired the national task force on coronary artery disease in competitive athletes. Professor Thompson, how should an athlete with a high coronary calcium score be treated? Should the athlete keep training and competing?
Dr. Paul D. Thompson, MD: High levels of coronary calcification in endurance athletes are not benign. Initially, we thought it was just calcification, but now we know it is not just coronary calcification. There is also soft plaque there.
Dr. Paul D. Thompson, MD: Calcified plaque is thought to be pretty safe, but uncalcified or partially calcified plaque can rupture and lead to a heart attack and sudden cardiac death. So how should these patients be treated? They should be treated with aggressive lipid reduction.
Dr. Paul D. Thompson, MD: They are just like regular patients. They should be treated with aggressive lipid reduction, just like you would treat anyone who has known coronary disease, because we know that the presence of coronary calcification, even in endurance athletes, is not benign. They need to get it down, because they have the same problem with suffering heart attacks and bypass surgery and needing angioplasty as regular patients who are not exercisers.
Dr. Paul D. Thompson, MD: Now, the good news is the athletes live longer for their coronary calcification. So it is not a terrible thing being an athlete. It is a good thing, but they do suffer the same sort of consequences.
Dr. Paul D. Thompson, MD: Should they stop exercising? No, but they should pay attention to themselves. They should forget the idea, get rid of the idea, that their exercise is some sort of a protective bulletproof vest.
Dr. Paul D. Thompson, MD: It is not. Athletes with high levels of coronary calcification can get heart attacks, strokes; they can get other things. They need to be treated aggressively to get their cholesterol level down.