• Mingjie Qiu, Bin Lv, Wei Lin, Jing Ma, and Hongmei Dong.
• Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
• Medicine (Baltimore). 2018 Dec 1; 97 (51): e13248.

RationaleThe Wolff-Parkinson-White syndrome (WPW) is a benign heart disease with accessory pathways, which can result in cardiac arrhythmias. The purpose of this case report is to introduce a rare case of sudden cardiac death (SCD) with a mild myocardial bridge and a history of WPW.Patient ConcernsA 25-year-old man with known WPW syndrome died at night while sleeping.DiagnosesDiagnosis of WPW syndrome is based on typical electrocardiogram findings with a documented dysrhythmia before the victim's death.InterventionsAt autopsy, no traumatic injury or common poisons were found, only a slight myocardial bridge was detected. We performed whole exome sequencing and identified several genetic variations related to SCD.OutcomesWe considered that the cause of death in this case was SCD in which arrhythmia might play an important role.LessonsThis case highlights SCD can occur in WPW patients with mild or unrecognized structural abnormality. Postmortem genetic examination can assist the diagnosis of sudden cardiac death, especially when no lethal structural abnormality is found in the decedent.

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