From a forensic point of view, sudden death is mainly defined as rapid, unexpected and natural death [
1]. Most often, sudden unexpected death due to natural causes results from previously unknown cardiovascular diseases though extra cardiac causes should not be ruled out [
1,
2]. Viral myocarditis, defined clinically as an inflammation of the heart muscle caused by viral infection, is an insidious disease and a major cause of sudden unexpected death [
1‐
6] accounting for approximately 20% of cases in adults under 40. More than 20 viruses have been associated with myocarditis, causing mild to severe injury in the myocardium with ultimate manifestation of end-stage dilated cardiomyopathy and heart failure. Among them, CVB3, a small nonenveloped single-stranded and positive-sense RNA genome of the
Picornaviridae family and
Enterovirus genus [
7], has been implicated in 25% to 40% of acute myocarditis and dilated cardiomyopathy cases in infants and young adolescents. Myocardial inflammation could be detected in 1 to 9% of routine post-mortem examinations [
6]. The clinical diagnosis of myocarditis is made difficult by its variable and nonspecific presentations [
4,
8‐
10]. Histopathology is the cornerstone of the diagnosis. A uniform histopathological definition for diagnosis was presented in a consensus statement in 1987 [
4,
11‐
13]. According to Dallas criteria, the histopathological diagnosis of myocarditis is based on necrosis or degeneration of the myocytes (or both) and an adjacent inflammatory infiltrate [
11,
12]. However, the histopathological diagnosis of the disorder remains difficult [
14,
15]. The relations between the clinical presentation and the histopathological evidence of myocarditis are to be determined. Fatal cases provide a unique opportunity to study these questions as both clinical and histopathological data are available. Furthermore, myocarditis may be falsely recorded as the cause of death if no other obvious causes have been found. In this framework, the current study is aimed at investigating into how accurately viral myocarditis is involved in death when conventional histopathology is supplemented with immunohistochemistry and molecular pathology.