Sudden cardiac death during exercise, most commonly caused by a lethal arrhythmia, is always a tragic event. There is interest in the role of pre-participation screening to prevent these rare occurrences, but the evidence for its effectiveness is not conclusive.
The health benefits of regular exercise for both physical and mental health are irrefutable. With rare exceptions, the most useful prescription for people with stable cardiovascular disease is exercise. However, the stress of exercise may unmask unrecognised cardiac disease resulting in a cardiac event, with the worst outcome being sudden cardiac death (SCD). SCD during exercise, which is most commonly caused by a lethal arrhythmia, is a rare but always tragic event. In younger individuals (under 35 years of age), inherited conditions such as a cardiomyopathy or channelopathy are the most commonly identified causes, but the events often remain unexplained even after autopsy. In older individuals, atherosclerotic coronary artery disease becomes the most common cause of SCD, and it also accounts for a proportion of deaths in the younger population.