45-year-old marathon runner

The case

• 45 years old Marathon runner
• dyspnoea on exertion and loss of performance
• 2:35 h:min pb

Test findings

ECG

Treadmill

VO2 peak 38.3 ml/min/kg (99% pred.)

Bicycle

VO2 peak 46.7 ml/min/kg (121 % pred.)