Sudden cardiac death due to the Wolff–Parkinson–White syndrome: A case report with genetic analysis

RATIONALE: The 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 CONCERNS: A 25-year-old man with known WPW syndrome died at night while sleeping. DIAGNOSES: Diagnosis of WPW syndrome is based on typical electrocardiogram findings with a documented dysrhythmia before the victim's death. INTERVENTIONS: At 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. OUTCOMES: We considered that the cause of death in this case was SCD in which arrhythmia might play an important role. LESSONS: This 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.