Subacute Myocarditis with Malignant Progression in a Young Patient: Contribution of Cardiac Magnetic Resonance

Introduction

Myocarditis can have a varied clinical presentation ranging from chest pain and mild dyspnea to cardiogenic shock and sudden death. It is defined as myocardial inflammation with myocyte necrosis or degeneration without ischemia and may result from infectious and non-infectious causes, with viral myocarditis being the most prevalent etiology. Myocarditis most commonly affects young male adults, being detected in up to 12% of patients aged under 40 years who had sudden death. Its diagnosis is fundamentally based on clinical suspicion due to recent viral infection associated with a current myocardial lesion, the absence of previous heart disease, and heart failure (HF) of no other apparent cause. Cardiac magnetic resonance (CMR) imaging findings can currently help confirm the diagnosis.

The low availability of endomyocardial biopsy, the gold standard diagnostic method, brings major challenges to the management of myocarditis. On the other hand, the increased use of CMR provides important diagnostic and prognostic data. This report describes the clinical issues and CMR contribution in a case of myocarditis in a young patient.

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