I've got this patient -- 43 year-old guy, overweight, but lifts weights at my gym sporadically. Unfortunately he doesn't do any cardiovascular exercise.
Initially I saw him because he came into the emergency room with atypical chest pain that was probably acid reflux. The pain went away when he belched. Someone nonetheless decided to do a stress test on him, which showed an abnormality.
So he guy sees me in the office. I tell him he probably has some coronary artery disease, but that this pain isn't this heart. He needs to lose weight and exercise by doing some cardio, not just lifting weights.
He tries to lose weight, without much success. He doesn't do the cardio because it tires him out -- guess what, if you're not exercising, yes it's going to be tiring. And, the pain continues.
Finally, to set the issue to rest, I send him for a heart catheterization. I expected some minor abnormalities in his coronary arteries. Instead, his arteries look perfectly clean. The stress test was wrong, and his pain is definitely not his heart.
I see him at the gym still. The pain is much better -- I really think it's acid reflux. And, I saw him on a stairmaster for at least 30 minutes!!!!!! I walked up to him (it's always a little weird running into patients when I'm sweating at the gym myself), gave him a thumbs up and told him to keep up the good work.
Small things make me happy. I hope he keeps it up.