Balsalazide-induced myocarditis

A 38 year-old man with ulcerative colitis recently treated with balsalazide was admitted with chest pain. Investigations demonstrated myocardial necrosis, ECG changes, echocardiographic wall motion abnormalities but normal epicardial coronary arteries and no LV scar on cardiac MRI. Myocarditis was diagnosed and balsalazide therapy was withdrawn, resulting in a full recovery and resolution of abnormalities.