https://doi.org/10.4081/ecj.2026.14929
Aborted exercise-related sudden cardiac death in a young athlete: a case report
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Published: 17 July 2026
Pediatric Out-Of-Hospital Cardiac Arrest (OHCA) is a rare but devastating event with an incidence of less than 10 cases per 100,000 population. We present a case of exercise-induced cardiac arrest in a previously healthy adolescent athlete, ultimately diagnosed with an anomalous origin of the left coronary artery. A 12-year-old athletic boy with no significant medical history experienced syncope at the finish line of a 3000-meter race. Initial assessment revealed severe hemodynamic instability progressing to cardiac arrest (bradycardic pulseless electrical activity) requiring cardiopulmonary resuscitation. Return of spontaneous circulation was achieved after 4 minutes. The patient subsequently developed acute pulmonary edema requiring emergency intubation. Cardiac computed tomographic angiography revealed an anomalous left coronary artery originating from the right coronary ostium with a malignant inter-arterial course. The patient underwent successful surgical reimplantation of the left coronary artery. He was discharged after 18 days with no neurological sequelae and subsequently returned to competitive sports with cardiologic clearance. This case highlights the importance of rapid emergency response and comprehensive diagnostic evaluation in young athletes presenting with exercise-induced cardiac events. Anomalous coronary arteries should be considered in the differential diagnosis of exercise-related syncope or cardiac arrest in seemingly healthy young individuals.
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1. Extracted from SwissRECA registry 2019-2023, unpublished data.
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CRediT authorship contribution
Magali S. Rüfenacht drafted the manuscript and was involved in the initial pre-hospital management of the patient. Tornike Sologashvili performed the surgical intervention and critically reviewed the manuscript. Fabienne Gebistorf was involved in the patient's intensive care management and critically reviewed the manuscript. Laurent Suppan was involved in the pre-hospital management of the patient, supervised the project, contributed to the conception of the case report, and critically revised the manuscript. All authors read and approved the final manuscript.
Data Availability Statement
All data relevant to this case report are included in the article. Additional information is available from the corresponding author upon reasonable request.
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