Sudden cardiac death in athletes.

Sudden death in athletes is a rare but tragic occurrence. Congenital cardiovascular abnormalities, usually asymptomatic and often undiagnosed during life, are the main causes in young athletes. Hypertrophic cardiomyopathy and congenital coronary anomalies are the most commonly occurring disorders. Idiopathic concentric left ventricular hypertrophy (non-physiological), arrhythmogenic right ventricular dysplasia and Marfan's syndrome with aortic rupture have also been implicated. Rarer causes include mitral valve prolapse and myocarditis. Coronary atherosclerosis is the major cause in older, and occasionally in younger athletes. Those involved in the medical care of athletes should be aware of the potential causes of sudden death in these groups. Symptomatic athletes should be fully investigated. Screening programmes are probably not justified on a cost effective basis.