DSP and inflammatory response: The DSP gene mutation has been recognized as one of the most associated with ‘hot phases’ of ACM.3,7 Acute myocardial inflammation in ACM seems to have an important role in the natural history of the disease, and it can precede the onset of histological and electrical abnormalities.8 Genetic testing in patients presenting with acute myocarditis-like syndromes has shown that a significant subset harbours pathogenic or likely pathogenic variants linked to hereditary cardiomyopathies.