Comparatively little is known about the risk of sudden death associated with exercise in young competitive athletes, and whether the benefits of sports activity outweigh the hazards of exercise-related fatal events is a clinical dilemma. This is only a small part of the story, however, as there are considerable effects of exercise whether it be at a competitive level or on a ‘leisure’ level on patients of all ages. This in itself is of massive importance to the cardiac patient population as exercise is a key component of effective recovery and recommended as central in the prevention of much cardiac disease.