The coexistence of myocarditis with acute streptococcal tonsillitis is rather infrequent. In a previous study,after a prospective evaluation of 100 consecutive cases of acute tonsillitis tested for cardiac involvement,there was only one clear-cut case of acute myopericarditis and 5 more patients with pathological findings suggestive of cardiac complications.Talmon et al ' described the presence of concurrent myocarditis in young men with tonsillitis.
The average latency from the onset of throat pain to the onset of chest pain was 4.6 days. All patients complained of chest pain, the most common ECG finding was transient ST segment elevations, and the levels of cardiac enzymes, including troponin, were increased in all of the patients.^ Apart from these studies, the rest of the literature includes only case reports, without cardiac MRI or endomyocardial biopsy evaluation