Acute myocarditis is an inflammatory disorder of the myocardium associated with cardiac dysfunction. The definition of myocarditis varies, but the Dallas criteria for myocarditis requires an inflammatory infiltrate and associated myocyte necrosis or damage not characteristic of an ischaemic event. Here we present a case of acute myocarditis in a 48-year-old woman masquerading as acute coronary syndrome. Patients with myocarditis usually have normal coronary arteries and we discuss diagnostic difficulties when it presents with ‘true’ acute coronary syndrome. In this case, cardiovascular magnetic resonance played an important role in the diagnosis of our patient and follow-up.
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