A 31-year-old man with confirmed monkeypox infection developed acute myocarditis approximately one week after the onset of symptoms of infection, according to a case study published in JACC: Case Reports. Myocarditis, an inflammation of the heart muscle, is usually caused by a viral infection. Previously associated with smallpox infection, a more aggressive virus, the case study authors explain that “by extrapolation, monkeypox virus could have a tropism for myocardial tissue or cause immune-mediated injury to the heart”. “Through this important case study, we are developing a deeper understanding of monkeypox, viral myocarditis, and how to accurately diagnose and manage this disease,” said Julia Grapsa, editor-in-chief of JACC: Case Report. . Skin lesion “The authors of this study have used CMR mapping, a comprehensive imaging tool, to aid in the diagnosis of myocarditis,” he continues. I congratulate the authors for this valuable case report during a critical time when monkeypox continues to spread throughout the world.” The patient presented to a health center five days after the onset of monkeypox symptoms, which included malaise, myalgia, fever, and multiple swollen lesions on the face, hands, and genitalia. Monkeypox infection was confirmed with a PCR swab sample from a skin lesion. The patient returned to the emergency department three days later, reporting tightness in the chest that radiated down the left arm. The patient was admitted to an intensive care unit after an initial routine examination with clinical suspicion of acute myocarditis. The initial ECG showed sinus rhythm with nonspecific abnormalities of ventricular repolarization, and routine laboratory tests revealed elevated levels of C-reactive protein, creatine phosphokinase (CPK), high-sensitivity troponin I, and brain natriuretic peptide (BNP), all of which can indicate a stress injury to the heart. The results of the cardiac magnetic resonance imaging (CMR) study performed on the patient were consistent with myocardial inflammation and a diagnosis of acute myocarditis. Cardiac involvement “This case highlights cardiac involvement as a possible complication associated with monkeypox infection,” explains Dr. Ana Isabel Pinho, from the department of cardiology at the University Hospital Center of São João, Portugal, and lead author of the study. study. “We believe that reporting this possible causal relationship can make the scientific community and health professionals more aware of acute myocarditis as a possible complication associated with monkeypox – he highlights – and could be useful for close monitoring of affected patients. to recognize other complications in the future. The patient was discharged after one week with a complete recovery. The authors state that more research is needed to identify the relationship between monkeypox and cardiac injury. Symptoms Monkeypox is transmitted by close contact with lesions, body fluids, or respiratory droplets. In addition to the rash, symptoms may include fever, chills, swollen lymph nodes, respiratory symptoms, and muscle aches. Most infections are mild, and symptoms can last two to four weeks. Vaccination is recommended for people with known or suspected exposure to the virus.