Abstract / Summary
Myocarditis can closely mimic acute myocardial infarction (AMI), particularly in young patients without atherosclerotic risk factors. We report a 27-year-old man with recurrent severe chest pai7n, transient ST-segment elevations, and markedly elevated high-sensitivity troponin-T, in whom coronary angiography was repeatedly normal. Serial cardiac magnetic resonance and 18F-fluorodeoxyglucose positron-emission tomography revealed a migratory pattern of myocardial inflammation, with new lesions emerging as earlier ones resolved, fulfilling criteria for recurrent myocarditis. Recurrent oral ulcers, folliculitis, arthralgias, and pathergy-like skin reactions raised suspicion for Behçet's disease. Treatment with vasodilators, colchicine, corticosteroids, and azathioprine produced sustained clinical and biochemical remission. This case highlights the importance of considering myocarditis in young patients with recurrent angina-like symptoms and normal coronaries, the value of serial multimodal imaging in detecting migratory inflammation, and the recognition of Behçet's disease as a rare underlying cause of recurrent myocarditis.