“…A peculiar aspect of our patients is that she had a fulminant AM with severe depression of LVEF and hypotension as the first manifestation of ACM. In the aforementioned studies, the majority of patients carrying mutations in the desmosomal genes had preserved EF during the myocarditis phase with district a/hypokinesias, although they had a higher arrhythmic risk and an extended LGE at CMR [ 25 ]. The onset with fulminant AM is more frequently seen in patients who subsequently develop DCM although the areas of LGE at CMR are less extensive [ 2 ].…”