Myocarditis is defined as an inflammatory process of the heart muscle. The symptoms are often nonspecific, and it can mimic acute coronary syndrome. Although the majority of patients recover fully, in some cases myocarditis can lead to dilated cardiomyopathy and even death. Available diagnostic tools are unsatisfactory and there is a need to develop noninvasive techniques that can aid diagnosis, prognosis, and follow-up. Contrast-enhanced magnetic resonance imaging is a valuable tool for the evaluation of inflammatory heart diseases such as myocarditis. We describe a 39-year-old man presenting in the emergency department with chest pain, ST segment elevation and elevated cardiac enzymes, who was treated initially with thrombolysis. Coronary angiography showed normal coronary arteries. Magnetic resonance imaging showed focally delayed uptake of gadolinium with a patchy pattern typical of myocarditis.
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