eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2020-07-03 8 10 358 360 10.12691/ajmcr-8-10-9 AJMCR20208109 article Sana Ahmad sahmad11@northwell.edu 1 William Chang 1 Lenox Hill Hospital, Department of Internal Medicine, New York, NY, 10075 Exercise is recommended for both primary and secondary prevention of cardiovascular disease. Exercise-associated elevations of cardiac biomarkers can be present especially after prolonged and strenuous endurance exercise bouts but the exact mechanism and clinical significance is unclear [1]. This case report is of a patient with recent increase in exercise activity who presented to the emergency department with atypical symptoms and increasing cardiac biomarkers concerning for myocardial infarction. He was admitted and taken for left heart catheterization which showed non-obstructive coronary artery disease. The lack of awareness of this phenomenon may lead to inappropriate management of these patients. http://pubs.sciepub.com/ajmcr/8/10/9/ajmcr-8-10-9.pdf Exercise-induced troponin elevation cardiac biomarkers strenuous exercise troponinemia cardiovascular health