Postmortem studies of patients with ACM have revealed T-cell infiltrates and other features of myocarditis,19,20 including presence of cardiotropic viruses.38 Mechanistically, cytokine exposure can disrupt desmosomal plakoglobin,39 and enteroviral protease-2A can cleave dystrophin, leading to functional impairment.40 Autoimmunity may also play a role, with anti-heart and anti–intercalated disk antibodies present in sporadic cases with ACM and relatives.25,41. Here, DMD is linked to myocarditis.