We describe the case of a 49-year-old woman with metastatic renal carcinoma receiving treatment with high-dose interleukin-2 (IL-2) who developed acutely progressive dyspnea on exertion and an elevated troponin level. Cardiac magnetic resonance imaging (CMR) was used to establish the diagnosis of IL-2-associated cardiotoxicity, differentiating myocarditis from acute coronary syndrome (ACS) and preventing an unnecessary invasive coronary angiogram.<Learning objective: ACS and myocarditis can present with similar symptoms and elevation in troponin levels. For individuals that lack significant risk factors for coronary artery disease, cardiac CMR may be used to differentiate ACS from myocarditis and avoid unnecessary invasive testing.>
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