Introduction

The death of any young person is a devastating event, and the death of a young athlete, apparently in the peak of health, even more so. While not common, occurring in 1–2 per 100 000 athletes per year,1 these events are reported in the media and can feel devastating to the whole community. Approximately half of sudden deaths in athletes are due to cardiovascular causes,2 3 As shown in figure 1, different studies have shown different results regarding most frequent aetiologies of sudden death in athletes. Early studies suggested hypertrophic cardiomyopathy (HCM) to be the most frequent cause.2 More recent studies have described the plurality of athlete sudden deaths as ‘autopsy negative', suggesting channelopathies, which cannot be diagnosed through anatomic autopsy, may be more common.4–6 Regardless of specific breakdown, HCM, long QT syndrome, other cardiomyopathies and channelopathies, anomalous coronary arteries and aortic disease underlie the bulk of cases of sudden cardiac death (SCD) in the athlete.