Dramatic footage has emerged showing the moment unconscious US synchronised swimmer Anita Alvarez was dragged out of a pool in Budapest after fainting in the water as she finished her routine at the World Championship yesterday.
Coach Andrea Fuentes had to plunge into the water to rescue 25-year-old Alvarez after lifeguards failed to react as she sunk in the pool.
Amazingly, it is the second time Fuentes has saved the swimmer after she was filmed diving in and pulling her to safety when she fainted in the pool during an Olympics qualifying event in Barcelona last year.
Alvarez regained consciousness soon after being rescued from the Budapest pool, received immediate first aid and is reportedly recovering well. Footage of yesterday's event shows the US swim team celebrating as Alvarez finishes her solo routine before realising something is wrong and moments later, the 25-year-old is seen being dragged from the pool by Fuentes and a male lifeguard.
Fuentes later revealed Alvarez stopped breathing for 'at least two minutes' during the ordeal following her performance in the women's solo free event.
'I tried to wake her up. Well, I slapped her and opened her jaw. But the truth is that until after we got to the emergency room, she did not breathe for at least two minutes,' Fuentes said during a Spanish-language interview last night.
The US coach, who was critical of lifeguards after the near-tragedy, had said last night a decision on whether Alvarez would swim in the free team finals tomorrow would be taken on medical advice. But today the 39-year-old mum-of-one said Alvarez was determined not to abandon the World Championships.
She told Spanish daily El Mundo: 'She doesn't want to leave here with the photo of her unconscious at the bottom of the pool. In any case in the team events Anita does a lot of pirouettes and very few apneas so she will almost certainly compete.'
Dramatic footage shows the moment Anita Alvarez was pulled unconscious from the bottom of a pool in Budapest while competing in the World Championship yesterday
Video shows Alvarez's coach Andrea Fuentes dragging the talented 25-year-old to the side of the pool with the help of a lifeguard after she fainted moments after finishing her solo routine
Alvarez was dragged out of the pool onto a stretcher and taken for emergency treatment following the ordeal during which, her coach said, she stopped breathing for at least two minutes. Medics late on Wednesday said she was recovering
Anita Alvarez lies at the bottom of the pool in the Budapest World Championships after fainting mid competition yesterday
Alvarez's coach Andrea Fuentes said she had to leap in because 'the lifeguards weren't doing it'
Anita Alvarez is rescued by her heroic coach Andrea Fuentes after losing consciousness and sinking to the bottom of the pool at the World Championships in Budapest on Thursday
Another swimmer jumped in to help Fuentes after she got Alvarez's head above the water
A member of Team USA also jumped in to help drag Alvarez to the surface with the lifeguards accused of not doing anything to help
Alvarez (centre) regained consciousness soon after being rescued and is recovering well
It is not known what caused Alvarez to faint but synchronised swimmers often have to hold their breath for a long time underwater
It's not the first time the swimmer has fainted in the pool - she did so in Barcelona last year, and Fuentes also saved her on that occasion
The Olympic athlete gained consciousness shortly after she was dragged from the bottom of the pool by her heroic coach
The American swim team were left visibly shaken by the horrific near miss
Members of the US swim team watching the event were seen shouting as they watched on in horror as Alvarez fainted in the pool at the end of her routine
This is the second time Alvarez has fainted in a pool during a competition, with Fuentes again coming to her aid during the Olympics qualifying event in Barcelona (pictured)
Coach Fuentes dived into the pool in Barcelona to save Anita Alvarez after she fainted during the Olympic qualifying last year
Coach Fuentes and one of Alvarez's teammates help the 25-year-old synchronised swimmer out of the water after she fainted while performing a routine
Who is hero coach Andrea Fuentes?
Coach Andrea Fuentes is one of Spain's most decorated Olympian with four medals in synchronised swimming.
Andrea, 39, also has an astonishing 16 World and European Championship medals.
Her Olympic haul includes two silvers at the Beijing 2008 games in women's duet and the team competition and she also won bronze in the same events four years later at London 2012.
Andrea's only gold medal was in the 2009 World Championships in Rome in the Free Routine Combination and her amazing five golds at the European Championships were in the 2008 and 2012 finals held in Eindhoven in the duet, team and combination events.
She retired from elite competition in 2013 and became a coach the same year after a fall out between the national trainer Ana Tarres and the Royal Spanish Swimming Federation.
Andrea has an eight year old son Killian, through her relationship with Spanish gymnast Victor Cano, 44.
In 2018, her sister Tina, also a synchronised swimmer, died at 34 from cancer.
Speaking on Spanish radio about her heroics, Andrea said: 'She only had water in her lungs, once she started breathing again everything was ok. She's said she wants to swim in the final.
'It felt like a whole hour. I said things weren't right, I was shouting at the life guards to get into the water, but they didn't catch what I said or they didn't understand.
'She wasn't breathing and had a really high pulse rate; I went as quickly as I could, as if it were an Olympic final. When I got her out she wasn't breathing, her jaw was locked in place. There was water coming out and she still wasn't breathing.
'They got her out on her back and I put her on her side, because you can't breathe like that. She recovered very quickly. It was two minutes without breathing, and with your pulse at 180 you don't want to be two minutes without breathing.'
'It was a big scare. I had to jump in because the lifeguards weren't doing it,' Fuentes said afterwards. 'I was scared because I saw she wasn't breathing, but now she is doing very well. Anita is doing much better.'
The American swim team was visibly distressed by the horrific incident and were seen consoling each other by the pool afterwards.
Fuentes said she realised something was wrong when Alvarez 'went down and didn't react' rather than coming up after her routine. 'When a swimmer finishes, the first thing they want to do is breathe,' she said.
The coach said she motioned to lifeguards for help but they did not see her, 'so I jumped in myself. I went there as fast as I could. I went in even faster than when I was going for Olympic medals.'
Fuentes said Alvarez 'was not breathing' when she reached her but was revived and checked for signs of damage after the terrifying incident.
'Oxygen, glucose, heart, blood pressure, everything's fine,' she said, adding that Alvarez will rest today before returning to the pool because 'she has to swim the final'.
Speaking in an interview on radio in Spanish, the coach said: 'We have looked at many things and the pressure is good. We've done a CT scan on his brain, she's fine.'
'It has been, as you know, sometimes we see it happing in sport, cyclists, marathons in athletics vomit many times. She told me why?
'I said, as athletes, we dedicate ourselves to discovering where the limit is and sometimes we find it, and today you have found it, you have gone so far that your body said, girl, don't ask me anything else.'
She added: 'In our sport it happens sometimes, when we go without breathing for a long time, with very high pulses and sometimes the oxygen not getting where it has to get, we faint.
'But it is that we spend many hours in sync. What happens is, we do exercises to endure as much as possible for the competition, and today it happened during the competition.'
Alvarez told WIVB-TV she had fainted in previous training schedules, blaming the episodes on burnout.
Speaking to Spectrum News after she fainted in Barcelona last year, Alvarez said she had been in the pool for 14 hours the day before the incident.
'I didn't get enough sleep, honestly. By the time we got back, I had to be up at like 5:30 again the next morning to go back.'
She described a sensation of being in a 'hamster wheel' before losing consciousness.
'I could see the ceiling spinning, and that's the last thing I remember until I got to the wall.'
Alvarez told the outlet at the time that the incident was due to her demanding schedule but admitted she fought on, competing again later that day, because she was desperate to secure a return to the Olympics last summer.
'Going in the second swim that evening was extra nerve-wracking for me,' she said. 'I was not there through the end, but the fact that my muscle memory just kept me going and knew what to do in all of that, I think was pretty amazing.'
Alvarez was pulled out of the rest of the competition after securing a fourth place finish and a return to the Olympics.
Alvarez is seen moments before fainting as she competed in the Women Solo Free Final at the Budapest World Championships
The synchronised swimmer, who competed in the 2016 and 2020 Summer Olympics, is seen on the floor at the start of her routine
Alvarez initially appeared well as she performed her routine but the problems started when she went underwater
Fuentes also saved Alvarez when she fainted during an event in Barcelona in 2021 (pictured)
The 26-year-old, pictured alongside her coach Fuentes (left), was born in Buffalo, New York, and began synchronised swimming after graduating high school
Fuentes said in a post that doctors had checked all of Alvarez's vital signs and she 'feels good' after the scare in the pool
'They must look deeper for the reason': Three-time Olympic synchronised champion calls for more checks on Anita Alvarez
Three-time Olympic synchronised swimming champion Alla Shishkina has urged US officials to carry out more thorough checks on Anita Alvarez and to 'look more deeply' into the reasons why she fainted while competing at the World Championships and had to be rescued by her coach.
It comes as the 25-year-old is set to return to action just 48 hours after the incident as she is in line to compete in the team event on Friday.
Shishkina, who won gold medals in the team competition at three consecutive Olympics between London 2012 and Tokyo 2020, believes further checks should be conducted on Alvarez before the American competes again.
'I think the reason must be looked for somewhere deeper,' the Russian told Sport24. 'Maybe check the vessels of the brain, do an in-depth encephalogram.
'If a person loses consciousness like this, then obviously not everything is in order, you need to check your health. I wish that Anita was all right, but I would think about a full examination.
'Athletes are people who, even if it is dangerous to perform, will still do it.'
Shishkina claims Alvarez may have little choice to compete in the team event, given her standing in the squad, and suggested the problem experienced by the American was not caused by the warm temperatures in the pool.
USA Artistic Swimming said in a statement: 'Watching yesterday's medical emergency of 2x Olympian Anita Alvarez and subsequent rescue by coach Andrea Fuentes was heartbreaking for our community.
'She gave an exceptional solo performance and competed brilliantly in four preliminary and three final competitions across six days.
'Anita has been evaluated by medical staff and will continue to be monitored. She is feeling much better and using today to rest.
'Whether or not she will swim in the free team final on Friday, June 24th will be determined by Anita and expert medical staff.'
Fuentes summed up the situation by posting a statement on Instagram.
'Anita is okay - the doctors checked all vitals and everything is normal: heart rate, oxygen, sugar levels, blood pressure, etc... all is okay,' she wrote.
'We sometimes forget that this happens in other high-endurance sports. Marathon, cycling, cross country... we have all seen images where some athletes don't make it to the finish line and others help them to get there.
'Our sport is no different to others, just in a pool, we push through limits and sometimes we find them.
'Anita feels good now and the doctors also say she is okay. Tomorrow she will rest all day and decide with the doctor if she can swim free team finals or not.'
It's not the first time Alvarez has passed out in the pool.
Last year the 25-year-old fainted during an Olympics qualifying event in Barcelona, where she was also rescued by Fuentes.
'Unfortunately I've seen it happen to her before - never in competition, though,' Alvarez's mother Karen said at the time.
'I knew right away. On their last element, I could tell something was up. It was hard to watch, definitely.'
Alvarez finished seventh in the event, which was won by Japan's Yukiko Inui.
Most synchronised swimming routines require athletes to hold their breath for no more than one minute at a time.
In 2010, Olympic medal winner Fran Crippen died in an open water swimming event in the UAE.
The long distance champion was aged 26 when he competed in the 10,000m event.
Fellow swimmers only noticed he was missing when they reached the finish line, sparking a desperate search to find him.
His body was found two hours after the end of the race by deep sea divers 500 yards from the shore.
Other swimmers at the time said heat may have been a factor, with water temperature at 30C and competitors reporting heat-related symptoms after completing the race.
A report found Crippen died of a 'cardiac abnormality'.
It is the second time Anita Alvarez (left) has fainted in a pool during a competition, with Fuentes again coming to her aid during the Olympics qualifying event in Barcelona
Last year 25-year-old Alvarez (right, in USA team kit) fainted during an Olympics qualifying event in Barcelona, where she was also rescued by Fuentes
Alvarez (pictured) regained consciousness soon after being rescued from the pool, received immediate first aid and is reportedly recovering well
Fuentes (left) released a statement saying Alvarez (right) has recovered so well she could compete in another event on Saturday
Last year the 25-year-old fainted during an Olympics qualifying event in Barcelona, where she was also rescued by Fuentes
The American swim team was visibly distressed by the horrific incident and were seen consoling each other by the pool afterwards
In 2015, a Dartmouth College swimmer died at a YMCA pool after making an attempt to complete four laps underwater without surfacing to breathe.
Tate Ramsden, 21, of Nashville, Tennessee, was pronounced dead at the Sarasota pool in Florida after lifeguards and emergency medical personnel could not revive him, according to the Sarasota County Sheriff's Office incident report.
Ramsden was at the pool with his sister, uncle and a cousin.
'Tate had been swimming laps in the pool for some time and I was told he had swam approximately 4,000 yards before practicing his underwater swimming techniques,' Officer Douglas Stidham wrote in the report. 'It is believed he was likely attempting to complete a '100' which is four laps across the pool without surfacing for air.'
At some point, Ramsden's sister and cousin noticed that he was not moving underwater, and they alerted lifeguards who pulled him out of the water, Stidham wrote.
Water and blood came pouring from Ramsden's nose and mouth throughout the attempts to revive him, according to the report.