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The prevention of sudden death in athletes is one the greatest challenges in sports cardiology. Early identification of athletes at high risk of sudden death can lead to difficult decisions such as restriction of competitive sports activity, but also treatment with medications and implantable cardioverter-defibrillator. We report a case of a 41-year-old female triathlete who had recurrent syncope during exercise with documented polymorphic ventricular tachycardia and nonspecific abnormalities on endomyocardial biopsy. Against medical advice, she continued to participate in athletic events and subsequently had a sudden cardiac death during a cycling event.
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