A father of five in Perth, Australia, suddenly dropped dead while he was on his morning jog.
Ben Beale, 47, was jogging to prepare for a charity boxing fight when he suffered what medics at first thought was a "catastrophic one-off" heart attack.
He had been medically cleared just a week prior to the event and tests before his sudden passing showed he had a low probability of having a heart attack in the future.
Professor Jason Kovacic, executive director of the Victor Chang Cardiac Research Institute in Sydney, said Mr Beale had an elevated rate of the little-known cholesterol lipoprotein (a) - known as Lp(a) - which was a contributing factor in the medical emergency.
He says this little-known form of cholesterol increases the risk of strokes and heart attacks in younger people.
Prof Kovacic said the data linking Lp(a) to higher levels of strokes and heart attacks is "unquestionable".
It is believed that up to one-fifth of the population may have at least a mild elevation of Lp(a).
Prof Kovacic, however, said many medics as well as ordinary people were completely unaware of Lp(a) which he called the "second bad cholesterol."
LDL cholesterol is largely known as "bad cholesterol". High levels of LDL are usually related to the individual's lifestyle and increase the likeliness of heart disease and stroke.
Unlike LDL, Lp(a) levels are thought to mostly be genetic so even those who try their best to keep healthy can have high levels.
Cardiologists have found increased levels of Lp(a) in families with a history of heart attacks and in people who have had heart attacks and strokes in their 30s.
Speaking to The Sydney Morning Herald, Prof Kovacic said that high levels of Lp(a) could be responsible for heart attacks among younger, healthier people.
"We have long wondered why healthy people with low cholesterol levels and seemingly no other major risk factors like smoking or diabetes can suffer heart attacks," he said.
Prof Kovacic said the resulting autopsy showed he had "extensive cholesterol and fat in the walls of his arteries."
"That's what we see in people that have genetically higher levels of Lp(a) … they just have rapid progression of a lot of cholesterol and fat laid out in the walls of their arteries, and they just have a heart attack early on before the thing's even had an opportunity to harden [into calcium]," the cardiologist said.
Beale's autopsy results also showed he'd already had two to three heart attacks before the fatal one, and that a part of his heart was already essentially dead.
Beale said her husband was "extremely fit" and regrets that he didn't have any blood tests done when he was still alive.
