This is a 33-year-old professional male cyclist. On February 15th, 2006 he underwent the annual medical and cardiovascular check-up in our Institute required for continuing professional cycling. Familial history revealed no known congenital or other cardiovascular diseases and no known cases of premature (<50 years) sudden cardiac death in close relatives. Personal history showed no exercise related cardiovascular symptoms, thoracic pain, dizziness, or palpitations. However, exercise bronchial hyper-responsiveness had been documented and treated with terbutaline and budesonide for 6 years.