Left Ventricular Tubercular Myocarditis with Unique Imaging Features on Cardiac MRI: A Case Report

  • Pratyaksha Rana Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, Gujarat, India.
  • Megha Sheth Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, Gujarat, India.
  • Archit Dikshit Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, Gujarat, India.
  • Saurabh Deshpande Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, Gujarat, India.
  • Milin Garachh Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, Gujarat, India.
  • Samir Patel Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, Gujarat, India.
  • Payal Tripathi Department of Pathology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, Gujarat, India
  • Dinesh Patel Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, Gujarat, India.
Keywords: Myocarditis; Cardiac MRI; Case Report

Abstract

Myocarditis is a rare manifestation of tuberculosis, often associated with high morbidity and mortality. Cardiac magnetic resonance imaging (MRI) is a critical imaging tool for assessing infiltrative myocardial conditions. We describe the case of an adult patient from a tuberculosis-endemic region who presented with sudden-onset symptomatic arrhythmias. Cardiac MRI findings included heterogeneous signal intensity in the left ventricular myocardium, altered myocardial nulling time, and a patchy “zebroid-like” pattern of late gadolinium enhancement. Additionally, necrotic supraclavicular and retroperitoneal lymphadenopathy were observed. Fine-needle aspiration cytology of the affected lymph node revealed epithelioid inflammatory granulomas. The patient was diagnosed with disseminated tuberculosis and tubercular myocarditis. Following the initiation of a standard anti-tubercular regimen, significant clinical improvement was noted at the 2-month follow-up.

Published
2025-04-26
Section
Articles