Acute Viral Myocarditis in a Young Woman: A Trigger for an Arrhythmogenic Cardiomyopathy Hot Phase?

Myocarditis and arrhythmogenic cardiomyopathy (ACM) are related entities in a significant percentage of patients, sometimes representing the initial form of presentation.

This report presents the case of a young woman with recurrent episodes of myocarditis with arrhythmogenic profile as an initial manifestation during the hot phase of ACM.

Hot phases related to myocarditis as a debut form of ACM are relatively common, occurring in up to 8% of acute myocarditis cases. In this patient, warning signs such as young age, malignant arrhythmias, and recurrence suggested an underlying cardiomyopathy. The presence of parvovirus B19 supports its role as a trigger. In the absence of a genetic diagnosis, biopsy confirmed characteristic fibroadipose substitution of ACM.

Arrhythmic debut of myocarditis should raise suspicion of a possible ACM. Recurrent myocarditis affecting multiple territories could be related to the hot phase of ACM.