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

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

Exertional heat stroke, Multiorgan dysfunction, Rhabdomyolysis, Cardiac injury, Low- and middle-income
countries, Emergency preparedness

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 one-
month 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

Ninh Xuan Nguyen1*, Ngoc Tien Pham1

, Huong Thi Thanh Le1

, Quoc Viet Tran1

, Hang Ngoc Thuy Tran1
,

Thi Kim Thanh Vo1

and Phong Van Phan2

https://doi.org/10.1186/s12245-025-01071-3

2026

peri irawan

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