Physical activity reduces the risk of cardiovascular diseases and is associated with lower mortality in middle-aged men. Therefore sudden cardiac death during sport activities has a profound impact on relatives, society and athletes. On the other side, the implications of practising sports on the risk of sudden death are discussed. Highly trained athletes show morphologic cardiac changes, that are present as a consequence of several determinants, including: type of sport, gender, inherited genetic factors. The predominant causes of sudden death in professional athletes are: atheromatous coronary disease (over 30 years) arhythmogenic cardiomyopathy, hypertrophic cardiomyopathy and idiopathic left ventricular hypertrophy (under 30 years). In 15-30% the cause of death is undetermined. On the ground at many professional studies, it is possible to draw general conclusion that the risk at sudden cardiac death in athletes is in the range of one for 200.000 sportmen/per year. It is relatively low index in comparison with general population. However, to avoid fatal incidents in professional sport, there is need to introduce medical examination as a useful method to identify those athletes with greater potential risk, as well as to purpose a few simple recommendations concerning the tests, that should be performed in each case.
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