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How does a 16-year-old die of myocardial infarction? It wasn’t just a mild myocardial infarction. I had to ask the pathologist what that meant. Troponin, which is an enzyme specific marker to the heart, was at 100 level, the number 100. You and I as adults are at one or two on a normal day’s level. The troponin in your heart tells it to keep beating. When you’re having a heart attack at 50, 60 years old, 70 years old, it would be marked at four to five. Think about it. You’re at 100. The heart was racing so fast it just kind of couldn’t do anything. It couldn’t pump the blood fast enough and that’s why he had a heart attack.

Young Athletes and Sport Participants at Risk: Ephedra Regulation and Legal Issues in the United States