Chikungunya Myocarditis Mimicking Acute Coronary Syndrome in an Elderly Patient: A Case Report

Chikungunya is a mosquito-borne viral infection. It causes mild fever, arthralgia, and rash in the majority of patients. Rarely, it can lead to serious cardiac complications such as myocarditis, primarily seen in patients with comorbidities. We present a 78-year-old elderly male with diabetes, hypertension, and dyslipidemia who presented with acute heart failure following a febrile illness. Initially, he was managed as an acute coronary syndrome. However, positive chikungunya IgM antibodies and a cardiac MRI demonstrating mid-wall and subepicardial late gadolinium enhancement confirmed chikungunya myocarditis. Chikungunya myocarditis is rare but can be seen in patients with comorbidities. Clinicians should maintain a high index of suspicion to diagnose myocarditis in patients with fever and cardiac symptoms. Early evaluation with imaging and serology will enable early diagnosis and help prevent adverse outcomes.