Myocarditis: A Rare Cardiac Manifestation of Antiphospholipid Syndrome | JACC: Case Reports | ACC.25

Mary Norine Walsh, MD, MACC, JACC: Case Reports Deputy Editor, is joined by author Alexander C Sacher, DO, discussing this study from Sacher et al presented at ACC.25 and published in JACC: Case Reports. Antiphospholipid syndrome (APS) is known for thrombotic events and pregnancy complications, but its association with myocarditis is rare and poorly understood. In this case, a 44-year-old female presented with acute chest tightness, elevated cardiac biomarkers, and severe anemia. Diagnostic workup revealed ST-segment changes on ECG, preserved left ventricular function on echocardiography, and myocardial inflammation on cardiac MRI, suggestive of acute myocarditis. Positive antiphospholipid antibodies confirmed APS. She was managed with close multidisciplinary follow up. This case highlights the role of cardiac MRI in diagnosing myocarditis early, guiding management strategies, and the need for heightened clinical suspicion in APS patients presenting with cardiac symptoms.