Acute Viral Myocarditis Diagnosis by Cardiac Magnetic Resonance Imaging

Clinical History A previously healthy 26-year-old male presented after 4 days of episodic epigastric and chest pain, noting a recent viral prodrome (vomiting, fever, and headache) which had resolved prior to the onset of chest pain. His physical examination and review of symptoms at the time of presentation was otherwise unremarkable. ECG showed PR depression and diffuse 1-2mm concave ST elevations in leads I, II, aVF, V2-V6 and ST depression in V1. Serum C-reactive protein (25 mg/L), troponin T (2.46; which subsequently peaked at 4.02), CK (1572) and NT-BNP (822) levels were also significantly elevated. He was presumptively diagnosed with myopericarditis of likely viral etiology and colchicine was prescribed.