APCU25CR26 A marathon turned nightmare: sudden cardiac arrest in a young adult following rapid weight losS

Introduction Sudden cardiac arrest (SCA) in young adults during endurance events is rare and often linked to inherited or structural heart disease. Coronary artery disease (CAD) is seldom suspected without major risk factors. However, rapid weight loss may act as a hidden stressor triggering cardiac events.Case Presentation A 27-year-old male with no known medical illness but a strong family history of ischemic heart disease collapsed during a marathon after 30 minutes of jogging. Emergency medical services found him in ventricular fibrillation. Return of spontaneous circulation (ROSC) was achieved after 20 minutes of CPR and two defibrillation shocks. Post-resuscitation ECG showed extensive anterior ST-elevation myocardial infarction (STEMI). Urgent coronary angiography revealed triple-vessel disease with acute total occlusion of the proximal left anterior descending artery, successfully treated with a drug-coated balloon. Laboratory tests showed significantly elevated LDL cholesterol (5.8 mmol/L) with normal fasting glucose and HbA1c. The patient had intentionally lost 32 kg over the past three months.Discussion This case highlights rapid, unsupervised weight loss as a potential precipitant of acute coronary events in young adults with underlying risk factors. Physiological stress from rapid weight loss and intense exercise may trigger arrhythmias and myocardial infarction. Elevated LDL and family history compounded risk. Early cardiovascular screening and safe, gradual weight loss strategies are essential for at-risk individuals.Conclusion Rapid weight loss can precipitate life-threatening cardiac events in young adults with predisposing factors. Awareness, screening, and supervised weight management are crucial to prevent such outcomes