Sport-related sudden natural death in the City of Birmingham.

We undertook a prospective study of all consecutive deaths reported to the Coroner for Birmingham and Solihull in a 5 year period. We identified 52 sudden deaths associated with symptoms commencing during sport participation. We studied the characteristics of these individuals. The majority had been performing at accustomed levels of activity without symptoms for several years. The extrapolation of our findings to preventive strategies remains unclear but we wish to highlight the importance of recognizing premonitory effort-related symptoms.