Myocardial bridging and de novo SCN5A variant: coincidence or cause in sudden cardiac death in the young?

Background: Sudden cardiac death in the young is a multifactorial condition often linked to undiagnosed genetic or structural causes in life. Myocardial bridge is a congenital malformation of the coronary arteries often underestimated, which can contribute to myocardial ischemia, fatal arrhythmias and sudden death. Case presentation: In this study, we present the case of a 23-year-old man who died suddenly without apparent cause. The autopsy revealed the presence of a complete myocardial bridge of the anterior descending artery and an apical thinning of the left ventricle. Genetic analysis performed post-mortem identified a de novo variant in the SCN5A gene. Conclusions: This case highlights the importance of molecular autopsy and the possible synergistic role between myocardial bridge and genetic in the pathogenesis of sudden cardiac in the young.