16 Vladimir Ilic, Sanja Mazic PHYSICAL CULTURE, BELGRADE, 62 (2008) 1-2 INTRODUCTION Favourable effect of continuous physical activity on functioning of cardiovascular system, as well as on prevention of primary and secondary cardiovascular diseases was well studied and confirmed by a great number of epidemiological studies (Leon et al., 1987; Paffenbarger et al., 1993). Athletes are considered the healthiest members of our society, therefore their unexpected death during training or competition draws high public attention. Sudden cardiac death (SCD) is the most frequent cause of death in professional athletes (Drezner et al., 2007; Maron et al., 1996a). Although the first death of an athlete was recorded in 490 B.C., when after 42 kilometers of running from Marathon battlefield to Athens, Greek soldier and the first marathon runner Pheidippides Vladimir Ilic, Sanja Mazic 616.12-036.88:796.071.2 Review CARDIOVASCULAR DISORDERS AS THE CAUSE OF SUDDEN CARDIAC DEATH IN ATHLETES Physical Culture, Belgrade, 62 (2008), 1-2, p. 16-28, tab. 4, pict. 6, ref. 45 Abstract Athletes are physically the most efficient members of our society with a unique lifestyle who are seemingly invulnerable and their unexpected death during training or competition draws high public attention. The most frequent cause of death in young athletes is the sudden cardiac death (SCD). The sudden cardiac death is defined as an event that is unexpected, and resulting from sudden cardiac arrest. In fact, syncope due to ventricular tachyarrhythmias during one hour is acute symptom in young athletes with or without heart disease. The aim of this study was to determine and describe the possible underlying causes of sudden cardiac death in athletes and to recommend the strategies to prevent SCD. More than 20 different causes of SCD in athletes have been described, but most cases result from a few distinct entities. The vast majority of sudden cardiac death in young athletes is due to congenital cardiac malformations such as hypertrophic cardiomyopathy and various coronary artery anomalies. In athletes over the age of 35, the usual cause of sudden cardiac death is coronary artery disease. Although there is no possibility to decrease the risk of SCD on zero especially in sport competitions, existence of clear recommendations for cardiovascular evaluation before athletic participation and side effect of sports activity, would minimize the frequency of SCD. Individuals with symptoms suggestive of cardiovascular disease should undergo thorough evaluation of risk of SCD according to permanent physical activity and sport competitive activity. Early identification of all causes of SCD in young athletes should help to prevent death by allowing the recommendation of abstinence from vigorous exercise and, if appropriate, initiation of medical therapy. Key words: SUDDEN CARDIAC DEATH / ATHLETES / PREPARTICIPATION SCREENING