**2. Causes of sudden death in athletes**

Disease processes causing SCD have changed remarkably over the years. In the 1970s, aortic valve stenosis, un-palliated cyanotic congenital heart defects (CHDs), and Eisenmenger's syndrome were the major culprits. In the 1990s, hypertrophic

cardiomyopathy (HCM), congenital anomalies of the coronary arteries (CAs), premature atherosclerosis, rupture of the aorta in Marfan's syndrome, and arrhythmias were identified as major diseases entities causing SCD in athletes [2]. At the present time, HCM; congenital anomalies of the CAs; Marfan's syndrome; structural cardiac defects, namely, repaired tetralogy of Fallot, repaired transposition of the great arteries by Mustard or Senning procedures, single ventricle lesions addressed by Fontan operation; CHD without prior surgery, including aortic is responsible for SCD [2–4]. Less common causes namely, acute or chronic myocarditis; complex forms of mitral prolapse, arrhythmogenic right ventricular cardiomyopathy (ARVC), Eisenmenger's syndrome; long QT syndrome; other abnormalities of the coronary artery such as Kawasaki disease and familial hyperbeta hyperlipoproteinemia; commotio cordis; catecholaminergenic polymorphic ventricular tachycardia; and Brugada syndrome were also found to be responsible for SCD [4–7]. Some of these entities will be reviewed in the ensuing paragraphs. In the US, SCD is seen more frequently following basketball and football than with other sports; this is likely to be related to the requirement for high level of physical activity in these sports [5, 6].
