Case presentation A 51-year-old lady had been admitted 9 months previ- ously with typical chest pain occurring at rest associ- ated with transient palpitations and dizziness. Her medical history was unremarkable apart from active smoking and ophthalmic migraine. The resting ECG was normal, but troponin I levels were slightly elevated at 4.1 µg/l. A transthoracic echocardiogram and coro- nary angiogram were normal. The patient was dis- charged with a suspected diagnosis of myocarditis because a cardiac MRI showed focal late Gadolinium THE INTERESTING ECG 27 Malignant arrhythmia associated with chest pain and a diagnosis of myocarditis Stéphane Noble, David Carballo, Haran Burri Cardiology Service, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland Cardiovascular Medicine 2011;14(1):27–28 Correspondence: H. Burri, MD Electrophysiology Unit Cardiology Service University Hospital CH-1211 Geneva Switzerland haran.burri@hcuge.ch The authors certify that there is no actual or poten- tial conflict of interest in relation to this article. Figure 1 Holter recording showing onset of a wide complex tachycardia corresponding to the clinical episode of chest pain and presyncope.