Conclusions Fundamental to the cardiovascular care of athletes is an understanding of the physiological cardiac adaptations in athletes that are manifested on the ECG. The ECG can provide valuable information when interpreted properly, accounting for the electrical and structural changes that are a common result of regular training. Distinguishing ECG findings related to athlete’s heart from changes suggestive of an underlying pathological disorder is critical to the identification of athletes at risk of SCD. Additional resources For a free online training module on ECG interpretation in athletes, please visit:http://learning.bmj.com/ECGathlete. For the November 2012 BJSM supplement on ‘Advances in Sports Cardiology’, please visit:http://bjsm.bmj.com/content/46/Suppl_1.toc. Competing interests None. Provenance and peer review Commissioned; internally peer reviewed. References 1 Harmon KG, Asif IM, Klossner D, et al. 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