Sudden cardiac death in young athletes is a devastating condition that occurs without warning. While most middle and high school athletes require pre-participation screening, many predisposing conditions go undiagnosed until they occur. The frequency of sudden cardiac death is often under reported because there is no mandatory system for reporting sports-related death in high school sports. Additionally, there is debate regarding the cost-effectiveness of more advanced screening tests such as electrocardiogram (ECG) due to high false positive rates.