Marathon runner, 48, had 90% blocked arteries: Cardiologist explains the hidden heart risk
New Delhi: He ran marathons, stayed physically fit and had none of the warning signs most people associate with heart disease. No chest pain. No unusual breathlessness. No obvious drop in stamina. Yet, at just 48, a Bengaluru marathoner reportedly discovered that all four of his major coronary arteries had severe blockages, ranging from 75 to 90 per cent.
The discovery came almost by chance. Despite feeling healthy, he decided to get his heart checked after his 52-year-old brother underwent angioplasty. There was another red flag hiding in plain sight: a family history suggesting that male members had tended to have shorter lifespans.
A CT coronary angiogram revealed the extent of the disease. The blockages were so severe and widespread that he required bypass surgery instead of angioplasty.
The case is a reality check for anyone who believes being able to run long distances automatically means the heart is healthy. Exercise is one of the best things you can do for cardiovascular health, but fitness on the outside does not necessarily reveal what is happening inside the coronary arteries.
So, how can someone run marathons with arteries that are severely narrowed? And are there subtle signs that physically active people should watch for?
How can a marathon runner have 90% artery blockage?
Speaking exclusively to News9 Digital, Dr Diwakar Kumar, Senior Consultant – Cardiology, Asian Institute of Medical Sciences, said physical activity should not be mistaken for complete protection against heart disease.
“As a doctor, I find cases like this particularly concerning because they remind us that being physically active does not necessarily mean that your heart is completely healthy. We often assume that someone who runs marathons, maintains a healthy weight and has good stamina is unlikely to have serious heart disease. Unfortunately, that is not always true,” Dr Kumar said.
“A 90% blockage in the coronary arteries is usually the result of a gradual build-up of cholesterol and fatty deposits inside the artery walls, a process known as atherosclerosis. Over time, these deposits can narrow the arteries and reduce the blood supply to the heart,” he added.
The doctor further explained, “What causes this? High cholesterol, diabetes, high blood pressure, smoking, chronic stress, poor sleep and family history are some of the major risk factors. In certain individuals, genetics can play a significant role, particularly when high cholesterol runs in the family. Sometimes, a person may have elevated cholesterol for years without knowing it because there are no obvious symptoms.”
In simple terms, running regularly can improve heart health, blood pressure, stamina and overall fitness, but it cannot erase every other cardiovascular risk factor. Someone can look lean, feel energetic and exercise regularly while still having high cholesterol or an inherited tendency towards coronary artery disease.
Can exercise protect you from heart blockage?
Dr Kumar explained, “While running and regular exercise are excellent for heart health, they cannot completely offset these underlying risk factors. I always tell my patients that exercise is important, but it should go hand in hand with regular health check-ups.”
Family history is something people cannot change through workouts or diet. Having a close relative who develops heart disease at a relatively young age can be an important piece of information to discuss with a doctor. In the Bengaluru marathoner’s case, his brother’s angioplasty prompted him to investigate his own cardiovascular risk despite having no apparent symptoms.
Can you have 90% heart blockage without symptoms?
Symptoms can differ from person to person, and some signs may be subtle enough to be mistaken for everyday tiredness or the after-effects of exercise.
For runners and gym-goers in particular, this can become tricky. Feeling tired, experiencing muscle discomfort or getting slightly breathless may be easy to write off as a tough workout.
Dr Kumar said, “The warning signs are something we should all be aware of. These include chest discomfort or tightness, especially during physical activity, unusual breathlessness, unexplained fatigue, dizziness or a sudden drop in exercise capacity. Some people may also experience discomfort in the arms, jaw, neck or back. Unfortunately, these symptoms are often dismissed as acidity, muscle soreness or normal exhaustion after a workout.”
“I would particularly urge people who exercise regularly to pay attention to any change in how their body responds to physical activity. If you suddenly feel more breathless than usual or experience chest discomfort while running, do not push through it,” he added.
Heart warning signs you should not ignore
Watch for chest pressure, heaviness or tightness during exertion, unexplained breathlessness, unusual fatigue, dizziness, reduced exercise tolerance or discomfort spreading to the arm, neck, jaw or back. Severe or persistent chest pain, particularly when accompanied by sweating, breathlessness, nausea, fainting or pain spreading to the jaw or arm, requires urgent medical attention.
Fit and over 40?
For people who exercise regularly, health check-ups can sometimes feel unnecessary. If you can run several kilometres without struggling, why worry? But fitness trackers, marathon timings and gym performance cannot measure cholesterol deposits building inside coronary arteries.
Dr Kumar said, “My advice is simple: do not wait for symptoms to get your heart checked. After 40, it becomes especially important to monitor cholesterol, blood pressure and blood sugar levels, and to understand your family history. Being fit is wonderful, but knowing what is happening inside your arteries is equally important. Heart health is not just about how far you can run; it is also about how well you are protecting your heart.”
Disclaimer: This article is based on the research and inputs shared by the doctor mentioned above and is intended for informational purposes only. The findings should not be considered medical advice or used for self-diagnosis or treatment. Consult a qualified healthcare professional for personalised guidance.