Work

Acute Myocarditis Presenting as Neck Pain With Severe Systemic Inflammation

Year: 2026

Type: article

Abstract: BACKGROUND: Acute myocarditis classically presents with chest pain, dyspnea, and arrhythmias; however, atypical and extracardiac presentations may delay recognition. We describe an unusual presentation characterized by unilateral neck pain, dysphagia, profound systemic inflammation, and reversible cardiogenic shock. CASE SUMMARY: A 35-year-old previously healthy woman initially presented with unilateral neck pain, dysphagia, and constitutional symptoms without chest pain or dyspnea. She developed hypotension requiring vasopressors, marked leukocytosis, thrombocytopenia, transaminitis, elevated cardiac biomarkers, and severe left ventricular dysfunction (ejection fraction 30%). Cardiac magnetic resonance showed elevated native T1 values and extracellular volume suggestive of diffuse myocardial injury. After infectious causes were excluded, corticosteroid therapy resulted in complete recovery within 1 week. DISCUSSION: Extracardiac symptoms initially obscured the diagnosis; parametric cardiac magnetic resonance mapping proved diagnostically valuable. TAKE-HOME MESSAGES: Myocarditis may present with atypical extracardiac inflammatory symptoms. Parametric cardiac magnetic resonance mapping can support diagnosis when conventional imaging findings are limited or absent.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2026.109796

Authors: Ayesha Fayyaz, Sher Wali Khan, Mariam Azam, Madiha Rabbani, Valaine Hewitt

Institutions: SUNY Downstate Health Sciences University, Seoul National University Bundang Hospital

Language: English

Topic: Viral Infections and Immunology Research

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850