Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 S1 2024 09 07 60 62 Pratyaksha Rana UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Megha Sheth UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Archit Dikshit UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Saurabh Deshpande UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Milin Garachh UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Samir Patel UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Payal Tripathi UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Dinesh Patel UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE 2024 02 22 2024 11 07 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. https://rhythm.tums.ac.ir/index.php/jthc/article/view/2031 https://rhythm.tums.ac.ir/index.php/jthc/article/download/2031/1183