Introduction: Myocarditis is usually difficult to diagnose because its clinical behaviour may be entirely asymptomatic. It is defined as inflammatory changes of the myocardium and could be associated with myocyte necrosis. Patients with myocarditis are regarded to be of high risk for perioperative complications, necessitating diligent anaesthetic management. Case Report: A 26-year-old male diagnosed with acute appendicitis, known history of cardiomyopathy and sub clinical hypothyroidism. Patient had history of palpitations and syncope since 2 years, consulted cardiologist diagnosed as cardiomyopathy with suspected myocarditis. He had preceding viral infection 2weeks ago. He was athletic and had satisfactory daily activity. pre-operative evaluation ECG showed sinus bradycardia, second degree atrioventricular block and T wave abnormality. 2d echo showed preserved ejection fraction 55% with LV dilation and normal chamber dimensions and normal pulmonary artery pressure. Patient was induced as per the standard anaesthesia protocol and maintained on O2, N2O and Isoflurane. blood pressure about 130/80 mm hg. Intraoperatively Blood pressure was maintained around 130 - 140 systolic BP. During laparoscopy, little fluctuation in HR and BP was managed well, extubated with out any problems. The main concerns of this surgery were to avoid intra operative arrhythmia and atrioventricular block and ST segment elevation. Utmost care was taken for fluid management and pain, patient was on post-operative observation to see for any signs of dyspnea and ST elevation. Conclusion: As the patient was posted for acute appendicitis with known history of myocarditis. Early intensive hemodynamic management and support was extremely useful to these patients. In view of haemodynamic collapse due to arrythmias, the anaesthetic management was planned successfully without any consequences.