Core Viewpoint - The article discusses two cases of acute myocardial infarction in 38-year-old men following intense physical activity, highlighting the risks associated with sudden strenuous exercise for individuals with underlying health issues [1][2][3]. Group 1: Case Studies - The first case involves a man who experienced severe chest pain after playing badminton for about 10 minutes, despite having lost weight and previously being diagnosed with significant coronary artery narrowing [1]. - The second case features a man who developed chest pain the day after hiking with his child, with a history of poorly controlled high blood sugar, leading to a confirmed heart attack [2]. Group 2: Mechanisms of Heart Attack Induction - Intense exercise can trigger myocardial infarction through three main mechanisms: plaque rupture, oxygen supply-demand imbalance, and coronary artery spasm [3]. - Plaque rupture occurs when increased heart rate and blood pressure during intense exercise cause unstable atherosclerotic plaques to break, leading to blood clot formation and artery blockage [3]. - Oxygen supply-demand imbalance arises when the heart's oxygen needs surge during strenuous activity, but blood flow cannot meet these demands due to existing arterial narrowing [3]. - Coronary artery spasm can be induced by sympathetic nervous system activation or electrolyte imbalances, leading to sudden blood flow interruption [3]. Group 3: Prevention Recommendations - Individuals at risk should undergo cardiovascular risk screening, including regular checks of blood lipids, blood sugar, blood pressure, and electrocardiograms [4]. - It is advised to assess cardiac tolerance before engaging in high-intensity exercise, especially for those who are sedentary or lack regular physical activity [4]. - A scientifically planned exercise regimen should follow a gradual increase in intensity, starting with low-intensity activities and avoiding sudden high-intensity workouts [5]. - Proper warm-up and cool-down routines are essential to prevent sudden stress on the heart and blood vessels during exercise [5]. - Individuals should avoid exercising in extreme weather conditions and refrain from high-intensity workouts when fatigued or unwell [5].