A 25-year-old male from a rural village in sub-Saharan Africa presents to the clinic with a 1-week history of progressively worsening chest pain, shortness of breath, and fatigue. He reports that the chest pain is sharp, located in the central chest, and becomes more intense with deep breathing or physical exertion. He also describes feeling unusually fatigued and has noticed mild swelling in his legs. The patient denies any recent trauma or known heart disease, but he mentions having a mild upper respiratory infection about 10 days ago that resolved with no medical treatment.

On physical examination, the patient is afebrile but appears mildly distressed due to shortness of breath. His heart rate is 110 beats per minute, and blood pressure is 105/65 mmHg. He has mild bilateral pedal edema and a faint S3 gallop. Auscultation of the lungs reveals mild crackles at the bases. Electrocardiogram (ECG) shows diffuse ST-segment elevations, and elevated cardiac biomarkers (troponin and BNP) are noted. An echocardiogram shows mild left ventricular dysfunction with no significant valve abnormalities.

Given his recent viral illness and symptoms of heart failure, the patient is diagnosed with acute myocarditis, likely triggered by a viral infection. He is started on supportive care, including diuretics for fluid retention, and referred for further monitoring and potential follow-up with a cardiologist.