Sudden cardiac death of a young competitive athlete is a rare but tragic event. 
Hypertrophic cardiomyopathy and coronary artery anomalies are the most frequent 
causes. Most cardiovascular abnormalities go unrecognized until the time of 
death owing to the lack of preceding signs or symptoms suggestive of disease. 
Physicians responsible for the care of athletes should be familiar with the 
various causes of sudden cardiac death, the physiologic adaptations seen in 
so-called athlete's heart, and existing cardiovascular screening guidelines. The 
preparticipation evaluation, although it has limitations, is the major 
instrument readily available for prevention of sudden cardiac death. Effort 
should be made to follow established consensus guidelines.