Key result
ICD and antitubercular therapy eliminate VT recurrence and symptoms in tuberculous myocarditis.
Why the study?
Myocardial involvement in tuberculosis is extremely uncommon and ventricular arrhythmias as the presenting manifestation of tuberculous myocarditis are rare and diagnostically challenging.
Case Report (n=1)
Demonstrates the complementary role of CMR and FDG PET-CT in diagnosing rare tuberculous myocarditis presenting as ventricular arrhythmias, successfully managed with ICD and antitubercular therapy.
Answers are grounded in this paper and cite their sources.
Supports considering tuberculous myocarditis in unexplained VT; hypothesis-generating for diagnostic strategies in endemic regions.
Myocardial involvement in tuberculosis is extremely uncommon and is often diagnosed only at autopsy. Ventricular arrhythmias as the presenting manifestation of tuberculous myocarditis are rare and pose important diagnostic and therapeutic challenges. A 36- year-old female presented with palpitations and sustained monomorphic ventricular tachycardia requiring electrical cardioversion. Baseline electrocardiography showed sinus rhythm with right bundle branch block, and transthoracic echocardiography demonstrated a structurally normal heart. Electrophysiological study revealed three distinct ventricular tachycardia morphologies, suggesting a diffuse arrhythmogenic substrate. Cardiac magnetic resonance imaging demonstrated myocardial oedema and late gadolinium enhancement involving the interventricular septum and lateral wall. Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET-CT) showed patchy myocardial uptake and multiple hypermetabolic cervical and mediastinal lymph nodes. Computed Tomography (CT)-guided lymph node biopsy revealed necrotising granulomatous lymphadenitis consistent with tuberculosis, and the tuberculin skin test was strongly positive. Given the high risk of recurrent malignant arrhythmias during the inflammatory phase, an implantable cardioverter-defibrillator was implanted prior to initiation of antitubercular therapy. The patient received antitubercular therapy with adjunctive corticosteroids and completed nine months of treatment. She remains asymptomatic on follow-up with no recurrence of ventricular tachycardia. The present case highlights the importance of considering tuberculosis in patients presenting with inflammatory ventricular arrhythmias in endemic regions and demonstrates the complementary role of cardiac magnetic resonance imaging and fluorine-18 FDG PET-CT in establishing the diagnosis and guiding management.
No takes yet. Share an insight, caveat, or question.
Nivetha et al. (2026) conducted a case report in Tuberculous myocarditis presenting as monomorphic ventricular tachycardia (n=1). Implantable cardioverter-defibrillator (ICD) and antitubercular therapy with corticosteroids was evaluated on Symptom status and recurrence of ventricular tachycardia. Treatment with an implantable cardioverter-defibrillator and antitubercular therapy eliminated ventricular tachycardia recurrence and symptoms in a patient with tuberculous myocarditis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: