Exercise is one of the most powerful tools for improving health overall. Yet, for a small number of students with cardiac conditions, exercise can sometimes be associated with the risk of sudden death, also called the exercise paradox.

The underlying causes of SCA can generally be placed into three broad categories:

* structural/functional, * electrical, and * other

Some factors that may increase the risk of SCA include:

* structural/functional causes including Hypertrophic Cardiomyopathy (HCM), coronary artery anomalies, myocarditis, and mitral valve prolapse;

* electrical causes including conditions such as Long QT Syndrome, Wolff-Parkinson White syndrome, ventricular fibrillation, and other types of arrhythmias that cause the heart to beat with an irregular rhythm;

* the use of drugs, such as cocaine, inhalants, “recreational” drugs, excessive energy drinks, diet pills, performance enhancing supplement, and some prescription medications; and

* other causes including blunt force trauma to the chest (commotio cordis); family history of known heart abnormalities, sickle cell trait or sickle cell disease, some auto-immune disorders, and sudden death before 50.

* Many of the conditions are known to be genetic and can be hard to identify or diagnose through routine examination. Accordingly, an annual pre-participation physical examination, including a detailed personal and family medical history, is critical to identifying potential causes of SCA.

* Although SCA happens unexpectedly, up to 72 percent of SCAs are preceded by symptoms which often go unrecognized, unreported, missed, or misdiagnosed.