Emergency Care Journal · Published 2026-07-17 · DOI 10.4081/ecj.2026.14929
Magali Rufenacht, Tornike Sologashvili, Fabienne Gebistorf, Laurent Suppan
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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Rufenacht, M., Sologashvili, T., Gebistorf, F., et al. (2026). Aborted exercise-related sudden cardiac death in a young athlete: a case report. Emergency Care Journal. https://doi.org/10.4081/ecj.2026.14929