Myocardial Infarction After Normal Responses to Maximal Exercise

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Abstract
The unexpected occurrence of acute myocardial infarction shortly after performance of a multistage test of maximal exercise by a normal 42-year-old subject is described. There was no evidence of infarction after this exhausting effort, but symptoms occurred immediately on exposure to hot water while he was taking a shower a few minutes later. Cardiac arrest from ventricular fibrillation occurred after ECG evidence of acute infarction. Following successful defibrillation and coronary care, there was satisfactory recovery from massive anterior wall infarction. Incidence, possible pathophysiological mechanisms, and precautions are cited.