PMC8450265_01
Initial electrocardiogram (ECG) demonstrating normal sinus rhythm with rate of 75 beats per minute. Subtle lateral ST segment elevation in lead I, II, V5, and V6 (arrow). No prior ECG was available.
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Initial electrocardiogram (ECG) revealed only subtle lateral ST elevations (Fig. 1).
Markedly abnormal cardiac magnetic resonance imaging consistent with an acute phase of biventricular myocarditis. Fig. A and B represent T2 sequence with associated edema (yellow arrows) and normal septum (red asterisk). Figures C-E represent late gadolinium enhancement (LGE). Fig. C indicates LGE of the mid-myocardium (yellow arrow). Fig. D indicates transmural apex involvement (yellow arrow). Fig. E indicates patchy enhancement of the myocardium (yellow arrow) as well as the right ventricle. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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Cardiac magnetic resonance imaging (cMRI) showed evidence of biventricular myocarditis and failure, with LVEF of 45% and RVEF of 41% (Fig. 2).