Abstract
Immune-related myocarditis may be challenging. We report the case of a 66-year-old man with a history of treated multiple myeloma by using immune checkpoint blockers, referred for angina. Coronary angiography was normal. [ 82 Rb]Rubidium PET/CT found diffuse abnormal stress myocardial blood flow and reserve and the apparition of epicardial calcifications. [ 68 Ga]Ga-DOTATOC PET/CT and CMR revealed chronic calcified myocarditis, which was confirmed by histology. This case emphasizes microvascular dysfunction in chronic active myocarditis as assessed by perfusion PET/CT.