Long Distance Running and the Heart: When Is Enough, Enough? "ΜΗΔΕΝ AΓAΝ" ("Nothing in Excess") -Temple of Apollo in Delphi Strenuous endurance exercise is associated with increase in catecholamines, heart rate, blood pressure, cardiac output, and myocardial oxygen consumption and a potential decrease in myocardial blood flow due to a decrease in diastolic time [6][7][8]. Volume and pressure overload may result in an acute increase in cardiac chamber size (especially right-sided chambers). These changes are more pronounced in individuals with less training. Strenuous exercise can also result in the accumulation of free radicals and lactic acidosis. In addition,