An unusual case of marathon-related exercise associated collapse. Case report and some considerations for medical care at endurance mass participation events

This article presents a unique exercise-associated collapse case during a marathon, highlighting the significance of evidence-based management for athletes on field. The patient, a 61-year-old experienced runner, collapsed near the finish line of the Milano City Marathon. He was aided immediately with CPR and AED. After excluding, through validated algorithms, common and life-threatening causes of collapse, the patient was transferred to hospital. The patient underwent diagnostic procedures, including CT and MRI scans, and hormonal tests that revealed pituitary hemorrhage and underlying coronary artery disease. Follow-up assessments and personalized care were instrumental in the patient's successful recovery and safe return to exercise.