Are we getting nearer to screening for atherosclerosis?

Case Presentation: A 48-yearold healthy man suffered a complex ankle fracture in a cross-country skiing accident that required orthopedic surgery. In the hospital, a routine 12-lead ECG showed a 1-mm ST depression in lead V5 to V6, which prompted a noninvasive coronary artery calcium test that had a high score. Therefore, a coronary arteriogram was done, disclosing 70% to 90% lesions in 3 major coronary arteries, which were balloon dilated. Thereafter, the ankle surgery was performed successfully. The patient admitted that he felt assured that, as a physically active nonsmoker with a normal total cholesterol value on a routine test years earlier, no need existed for medical or cardiac consultation despite his strenuous recreational activity.