Usha L. is a 16 year-old male who attended a routine follow up visit at his family doctor’s office. He would like to start playing competitive soccer and the coach asked for a doctor’s clearance. The patient’s family was pleased with the proactive approach the coach demonstrated, as they were also worried about the small but real risk of sudden collapse sometimes resulting in death in young elite athletes without previous diagnosis of heart disease. The coach was particularly concerned about ruling out any type of heart disease. Usha is active, athletic and asymptomatic. His past medical history is unremarkable. There is no family history of cardiac disease. He doesn’t smoke or use street drugs.