Journal of Experimental Pharmacology and Toxicology

Background: Myocarditis is a challenging polymorphic disease with extensive variability in clinical presentation. The etiology of myocarditis often remains undetermined without an endomyocardial biopsy. Case presentation: A 25-year-old male with no prior cardiovascular history presented with acute severe retrosternal chest pain, dyspnea, fatigability, and diaphoresis, preceded by mild respiratory symptoms. Physical exam revealed stability, and ECG showed inferolateral ST-segment elevation. Laboratory tests indicated significant myocardial injury with elevated troponin and CK levels, alongside inflammatory markers. Coronary angiography excluded acute coronary syndrome, and cardiac MRI confirmed active myocarditis with characteristic late gadolinium enhancement and myocardial edema. The patient remained hemodynamically stable during hospitalization. Guideline-directed medical therapy was initiated, including a beta-blocker, an ACE inhibitor, and dapagliflozin as an SGLT2 inhibitor to support ventricular recovery and prevent remodeling. At one-month follow-up, the patient was asymptomatic with normalized biomarkers and unremarkable imaging, indicating clinical recovery. Conclusion: This case illustrates that acute myocarditis may lead to early cardiac dysfunction even in young individuals and highlights the potential benefit of adding an SGLT2 inhibitor to standard therapy to support recovery. Full article