left ventricular tubercular myocarditis with unique imaging features on cardiac mri: a case report

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.