Stephen Dudley probably died when his heart developed a fatally abnormal rhythm brought on from the stress of being assaulted, says a forensic pathologist.
The 15-year-old died in hospital three years ago after he was punched during a fight following school rugby practice.
A coronial inquest into his death is being held this week.
Forensic pathologist Paul Morrow told the hearing the teenager had an undetected condition that had the potential to cause heart arrythmia and inflammation.
Dr Morrow said a microscopic lesion was found next to a key part of his heart.
He said other evidence showed Stephen was in a normal state after practice but became pumped up - at least psychologically.
Paediatric heart specialist Jonathan Skinner, who also gave evidence, said it might never be known exactly what caused the teenager's heart to move into the abnormal rhythm.
But he said more should be done to prevent similar deaths by putting more defibrillators in places where lots of people gather.
He also wanted more people to be confident about using CPR.