Abstract
BACKGROUND: Sudden cardiac arrest (SCA) in older individuals is often attributed to coronary artery disease and is rare in otherwise healthy individuals with good functional status. CASE SUMMARY: A healthy marathon runner experienced SCA during a race and was found to have severe undiagnosed coronary artery disease. He underwent percutaneous coronary intervention with a drug-eluting stent and made a full recovery. DISCUSSION: The incidence of SCA during long-distance running is 1 per 184,000 participants. Older individuals may have undiagnosed coronary artery disease as the underlying cause of SCA. TAKE-HOME MESSAGES: Although acute coronary events may be uncommon in patients with low atherosclerotic cardiovascular disease risk scores, a subpopulations of older endurance athletes may be at higher risk than anticipated. Older endurance athletes may benefit from refined risk assessments, and further research is warranted to assess available screening tools for this subpopulation.