4. Disturbances in the Electrical Conduction System
These disturbances of the heart rarely cause sudden death in athletes and other young people. In these cases, individuals are observed to have very slow heart rates and complete heart block.
5. The Brugada Syndrome
This can be a cause of sudden death, but is not often associated with sudden death in competitive athletes. In these cases, the ECG is always abnormal and is used to detect this very rare condition. For more information see the chapter Brugada Syndrome.
6. WPW and Long QT Syndrome
Sudden death in individuals with apparently normal hearts accounts for approximately 3% of deaths. Conditions that do not causes structural abnormalities and are therefore not detected on pathological examination at autopsy include: Wolff-Parkinson-White (WPW) syndrome and familial long QT syndrome. In WPW there is an
anomalous or accessory conduction pathway that allows rapid heartbeats in the range of 220–280.
A congenital abnormality of electrical conduction, the familial long QT syndrome, may escape detection because there is no structural abnormality to be found at autopsy.
Sudden death in athletes age 35–50 is common, because at this age asymptomatic and undetected coronary artery disease may be present. The coronary arteries may be involved with obstructive atherosclerotic disease that may cause a fatal or nonfatal heart attack or sudden death. Athletes over age 45 commonly have known atheroscle¬rotic disease, undetected dyslipidemia or diabetes, and those who persist as recreational joggers, marathon runners, or engage in high-intensity squash or tennis may succumb to sudden death.

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