10th May 2025

A 28-year-old lady presents with stabbing chest pain, which she describes as constant.

A 28-year-old lady presents with stabbing chest pain, which she describes as constant. She finds the pain worsens when lying down.  On full history taking she reports some shortness of breath on exertion. She is normally fit and well but does report generalised aching and a high temperature approximately 2 weeks ago. On examination, she is haemodynamically stable, with normal heart sounds and a non-displaced apex beat. The pain is reproduced by sitting the patient upright. During her admission, she is noted to have a small pericardial effusion and is therefore recommended for inpatient CMR.

Which of the following cardiac magnetic resonance (CMR) findings are suggestive of myocarditis?