Timeline of events

Time	Events
Prior to November 2017	The patient participated in moderate to intense aerobic activity several times per week
November 2017: Day 1	He presented with chest pressure to the emergency room and was found to have an elevated serum troponin I of 0.123 ng/ml and evidence of dyslipidemia with a fasting total cholesterol 235 mg/dl, direct LDL 170 mg/dl, HDL 38 mg/dl, and triglycerides 124 mg/dl. These findings, in conjunction with a family history of sudden cardiac death, led to an admission to the cardiology service for further evaluation
Day 2	CCTA showed mild, non-obstructive CAD in the left anterior descending artery. TTE showed mild LVH. Telemetry and serial ECG monitoring was unremarkable. The patient’s chest pressure resolved and he was discharged from the hospital
December 2017 through January 2018	The patient continued to participate in aerobic activity multiple times per week
Late January 2018	The patient presented for follow-up in clinic and was asymptomatic. Repeat laboratory values showed a serum troponin I level of 0.213 ng/ml, CK of 453 U/l (normal < 300 U/l). cMRI was unremarkable. He was started on aspirin (81 mg daily) and rosuvastatin (20 mg daily) and instructed to refrain from exercise until the next clinic visit in 1 week
Early February 2018	The patient presented to his second clinic visit and was again asymptomatic. Testing on serum from the prior clinic visit revealed the presence of a heterophile antibody. Repeat testing of his serum showed an improved lipid profile and a negative troponin I