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.