In reply to Rigid Raider:
What did he eat the previous evening?
As others say, I'd expect an already fit teenager to be able to easily perform despite missing food. Lack of hydration might be a factor? That's one of the biggest things that knocks me out, when I've been poorly hydrating before the actual exercise.
As for calorific values, clearly he hadn't input nearly what he output, but you'd need to take account of the previous days' food too as this will surely still be in his system.
Hope the cardiologist visit proves all is well.