Exertional heat stroke with multiorgan dysfunction in a community sports event - case report and one-month follow-up

Sep 30, 2026

Exertional heat stroke (EHS) is a life-threatening emergency marked by central nervous system dysfunction, hyperthermia, and frequent multiorgan injury. Despite improved outcomes from rapid on-site cooling in elite sports and military settings, evidence from community sporting events in low- and middle-income countries remains limited. This case report describes a 30-year-old Vietnamese man collapsing during a 5-km run with encephalopathy, seizures, metabolic acidosis, acute kidney injury, rhabdomyolysis, and myocardial injury.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Introduction

Case presentation

Nguyen et al. International Journal of Emergency Medicine (2026) 19:5 [https://doi.org/10.1186/s12245-025-01071-3](https://doi.org/10.1186/s12245-025-01071-3) International Journal of Emergency Medicine CASE REPORT Open Access Exertional heat stroke with multiorgan dysfunction in a community sports event: case report and one-month follow-up Ninh Xuan Nguyen 1*, Ngoc Tien Pham 1, Huong Thi Thanh Le 1, Quoc Viet Tran 1, Hang NgocThuy Tran 1, Thi Kim Thanh Vo 1 and Phong Van Phan2 Abstract Background Exertional heat stroke (EHS) is a life-threatening emergency characterized by central nervous system (CNS) dysfunction with hyperthermia and frequent multiorgan injury. Although outcomes have improved with rapid on-site cooling in elite sports and military contexts, data from community sporting events in low-and middle-income countries (LMICs) remain scarce. Case presentation We report a 30-year-old previously healthy Vietnamese male who collapsed during a 5-km community run. He presented with encephalopathy, generalized seizure, metabolic acidosis, acute kidney injury (AKI) (creatinine 149 µmol/L, estimated glomerular filtration rate (eGFR) 53), rhabdomyolysis (creatine kinase (CK) 3745 U/L), and myocardial injury (high-sensitivity troponin I (hs-troponin I) peak 3.87 ng/mL) . The electrocardiogram (ECG) showed incomplete right bundle branch block with minor ectopy, while echocardiography revealed preserved systolic function. With rapid cooling and supportive care, renal, muscular, and cardiac abnormalities resolved. At onemonth follow-up, hs-troponin I and CK had normalized (0 .0016 ng/mL; 155 U/L), creatinine was 81 µmol/L, and ECG was normal, confirming full clinical recovery. Conclusion This case illustrates EHS with multiorgan dysfunction successfully managed at a community sporting event in Vietnam. The comprehensive one-month biomarker and cardiac follow-up highlights the potential for full recovery, while emphasizing the need for cost-effective emergency preparedness-including trained staff and rapid cooling strategies-in LMIC community events. Keywords Exertional heat stroke, Multiorgan dysfunction, Rhabdomyolysis, Cardiac injury, Low-and middle-income countries, Emergency preparedness *Correspondence: Ninh Xuan Nguyen [v.ninhnx@vinmec.com](v.ninhnx@vinmec.com) 1Emergency Department, Vinmec Central Park International Hospital, Vinmec Healthcare System, Ho Chi Minh City, Vietnam 2Intensive Care Unit, Vinmec Central Park International Hospital, Vinmec Healthcare System, Ho Chi Minh City, Vietnam © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/l](http://creativecommons.org/l)icenses/by/4.0/. Nguyen et al. International Journal of Emergency Medicine (2026) 19:5 Page 2 of 6 Introduction Exertional heat stroke (EHS) is a life-threatening emergency defined by central nervous system (CNS) dysfunction with core temperature often but not always ≥ 40 °C, frequently accompanied by rhabdomyolysis, acute kidney injury, and myocardial injury [1, 2]. Because body temperature may decline before measurement, diagnosis depends on both clinical and systemic features. Mortality remains high if recognition and cooling a

FAQs

What is exertional heat stroke (EHS) and why is it dangerous?

EHS is a life-threatening emergency involving central nervous system dysfunction with hyperthermia and frequent multiorgan injury.

What events and clinical findings are described in the case?

A 30-year-old Vietnamese man collapsed during a 5-km community run and presented with encephalopathy, generalized seizure, metabolic acidosis, acute kidney injury, rhabdomyolysis, and myocardial injury.

How did the patient recover after treatment and follow-up?

With rapid cooling and supportive care, renal, muscular, and cardiac abnormalities resolved, and at one-month follow-up biomarkers normalized with full clinical recovery.

Sep 30, 2026

Uploaded by Aria Callaghan