Table 1.

Potential Triggering Mechanisms of Acute Myocardial Infarction by Strenuous Physical Exertion^*.

Induces plaque rupture via:

•increased heart rate, systolic blood pressure, and shear forces •altered coronary artery dimensions •exercise-induced spasm in diseased artery segments

Renders a fissured plaque more thrombogenic by:

•deepening the fissure •increasing thrombogenicity

Induces thrombogenesis directly via:

•catecholamine-induced platelet aggregation

^⁎Adapted from reference [58].