Cycling Wed: I told you so…

Dear Endurance Athletes, More than a year ago, I suggested that Ironman-distance triathlons were not heart healthy. Little did I know that expressing the notion that chronically inflaming oneself might cause permanent heart damage would be so controversial. This post led to my first experience with ad hominem comments. Obviously, talking about the upper limit […]

CW: Is marathon running really that safe?

The Sudden Death of Pheidippides

Imagine. Imagine the inflammation that the endurance-athletic community would have been spared? If only Pheidippides had lived. I mean, what was the rush? The battle had already been won. Athenians could have waited another few hours (or days) for the good word on the battle of Marathon. It’s not like someone was tweeting in 490 […]

A cautionary note to my endurance athletic brethren…

Exercise is good for you. It forms one of the triads of health: good nutrition, good movement, and good sleep. However, like in life, too much of anything is counterproductive, even destructive.   I have long struggled to explain the steady stream of hyper-fit, uber-athletic endurance athletes who see me for arrhythmias.  A membership in […]

Coronary CT scans for the evaluation of chest pain illustrates the health care expenditure debate…

During residency, there was always a case of mis-diagnosed chest pain to discuss in conference.  Incorrectly sending a patient home and missing the diagnosis of cardiac chest pain was an infrequent but repetitively observed phenomenon. So as to tread carefully with words, it is sufficient to say that even now, chest pain triage remains a […]