O’Donnell says his LAD was 80% blocked when he arrived at the hospital after an artery rupture, and doctors told him the blockage could likely have been 95-100% prior to the heart attack.
The above paragraph is from the article I saw about him. Well this guy definitely has a strong genetic predisposition for CAD. 75-80% blocked arteries patients might be asymptomatic due to collaterals, obviously his artery wasn’t occluded completely and sounds like didn’t thrombosed either. Likely he was symptomatic after the race and was taken for angiogram where they discovered an LAD occlusion of 80%. Once we get about 80% occlusion of arteries we can develop symptoms with exertion an athlete likely will have way more capability to tolerate moderate/intensive exertion than a sedentary person. I think this guy has bad genes and must keep a very close follow up with his Drs if he wants to live to an average age, because otherwise he won’t make it for sure.
So yes this guy has premature CAD, definitely genetic component cuz he is an athlete. He probably would have died in his 30’s if he was sedentary and smoker.
There’s very limited information about specifics in his Hx and case scenario, no labs or tests to review. So I would think he had a NTEMI, but not surprised if he had ekg changes due to prolong exertion (iron man).