[Sports death--an Internal Medicine problem?].

Sports means fitness and endurance, regeneration and balance, game and fun. Lack of physical exercise is one of the main risk factors for cardiovascular diseases. Terrifying and not conclusive in the public's mind are events of sudden death, in particular if those are of nontraumatic cause and thus of cardiovascular origin. Organic pathologic examination revealed that a higher proportion of males are affected by sports death. Only 7-9% of those events are related to women, although the percentage of active women among sports people accounts for nearly 50%. The relative risk increases with age and intensity of endurance. For people who are untrained or not used to train, the risk of sudden death is potentially higher. In athletes > 35 years of age, coronary artery disease (CAD) is the most common cause (85%) of sudden death. In the group < 35 years, CAD and acute myocarditis are the predominant causes of sudden death, but also hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), disorders of the conducting system, and Marfan's syndrome. Additional risk factors like acute infections and misuse of doping drugs require the care of a specialist in internal medicine and/or cardiology on top of the care by a specialist in orthopedics and accident/rehabilitation medicine. Physical examination as a precaution and prevention strategy should be available for leisure sports as well as for athlete sports.