Exercise and coronary artery disease: assessing causes and managing risks.

Abstract

Exercise has many benefits, but it is not completely risk-free. Many factors can contribute to cardiac events during exercise, including coronary artery disease (CAD) and nonatherosclerotic causes such as anomalous coronary arteries, myocardial bridging, and vasculitis. Myocardial infarction and sudden cardiac death are the two major problems in older patients with CAD, but most exercise-related deaths in young patients result from hypertrophic cardiomyopathy and coronary artery anomalies. Preexercise screening that includes a careful history, medical examination, and, for some, exercise testing, can stratify risk and mitigate potential problems during exercise.