Sudden death on the athletic field is usually due to underlying cardiovascular disease. Coronary artery disease is most common in older athletes, and a variety of congenital cardiovascular malformations predominate in young competitive athletes. Of these lesions, the most common in North America is hypertrophic cardiomyopathy. A variety of coronary artery anomalies are next in frequency, with the most important being anomalous origin of left main coronary artery from the anterior sinus of Valsalva.
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