Abstract
At one time or another, most physicians have encountered a patient -- perhaps even a friend or family member -- who suffered a heart attack during strenuous physical exertion. Some familiar examples include shoveling snow, recreational jogging, and sexual activity. Until now, however, a link between heavy exertion and the onset of myocardial infarction has been suggested mainly by temporal associations, anecdotal reports, and everyday experience. In this issue of the Journal, the commonly held notion that vigorous exercise can trigger heart attacks has been buttressed by solid evidence. The two new reports by Mittleman et al.1 in the United . . .