The most impoant cause of sudden death in professional footballer in setting of beta myosin testing being available is not HOCM but arrythmogenic right ventricular dysplasia. The Desmin gene is responsible for a defect in muscle of right ventricle leading to fibro fatty replacement of the muscle. These patients in setting of adrenergic stimulation can develop a VT or Torsades de Pointes leading to death on the football field. Takotsubo cardiomyopathy presents in setting of catecholamine surge like an emotional break-up or getting stuck in an elevator during an eahquake. ASD presents with exercise intolerance due to secondary pulmonary aery hypeension. An Eisenmenger patient will be so sick that he cannot be expected to be a football player.