Hypertrophic cardiomyopathy is considered a principal cause of sudden unexpected 
cardiac death in young athletes. However, a number of demographic features 
observed in these deaths are not consistent with the diagnosis. All of these 
characteristics instead share in common a propensity for ventricular 
hypertrophy, implying that these deaths may reflect electrical stability in the 
extremely rare athlete with exaggerated myocardial hypertrophy in response to 
sports training. This review provides an evidence-based line of reasoning that 
supports this concept.