Fig. 2.

CMR data findings of a 56-year-old male performed at day 2 after the onset of an acute coronary-like syndrome (chest pain, ST segment alterations, mild troponin elevation). Black blood T2-weighted STIR CMR indicates the presence of limited subepicardial hypersignal in the mid portion of the posterolateral and lateral LV walls, indicative of small foci of myocardial edema (top panel, arrows, 4 % LV mass). Late gadolinium-enhanced CMR shows limited subepicardial nodular lesions in the mid portion of the posterolateral and lateral LV walls (mid panel, arrows, 6 % LV mass), indicative of acute myocarditis. Cine-MR at day 2 and 6 months (bottom panel) showed altered systolic global LV function (LV end-diastolic volume index 83 ml/m², LV ejection fraction 45 %; 101 ml/m² and 36 %, respectively). Despite optimal medical therapy, the patient suffered NYHA Class III heart failure during follow-up with diffuse LV hypokinesia predominant in the lateral wall