[Athlete's heart: role of cardiac imaging in the prevention of sudden cardiac death].

Sudden cardiac death (SCD) in athletes is usually the result of an undetected underlying heart disease, with physical exertion acting as the trigger. Commotio cordis is a rare cause of SCD. In young athletes, genetically determined cardiomyopathies predominate, while in older athletes coronary artery disease remains the most important differential diagnosis. Regular screening programs - consisting of medical history, physical examination, and resting ECG - can detect over 90 % of relevant conditions, particularly when international ECG criteria are applied correctly. However, these assessments are not always sufficient, as some pathologies may manifest later in life and/or require additional diagnostic tests to be recognized. The main task of screening athletes is to distinguish physiological adaptations of the athlete's heart from pathological changes. Echocardiography, MRI, and CT play a central role here.