Sudden death in athletes occurs because of the existence of hidden 
cardiovascular disorders which, during effort, may jeopardize the electrical 
stability of the heart, triggering ventricular tachycardia and/or fibrillation. 
Apart from rare conditions of ion channel diseases in the setting of a 
structurally normal heart, in which the disorder may be easily diagnosed on 
basal or stress test ECG, cardiac abnormalities at risk of causing sudden death 
may affect the aorta (Marfan syndrome), the coronary arteries (congenital 
coronary artery anomalies, premature coronary atherosclerosis), the myocardium 
(hypertrophic and arrhythmogenic cardiomyopathy), the valves (bicuspid aortic 
valve, mitral valve prolapse) and the conduction system (pre-excitation 
syndromes). These structural heart disorders may be detected by ECG and/or echo. 
The employment of these tools at pre-participation screening can help to 
identify concealed anomalies, which may play a major role in early diagnosis, 
risk stratification, and prevention of sudden death.