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We present a case of auto-immune myocarditis and clarify the role of therapeutic testing in the management of this condition. We present the case of a 66-year-old man with no systemic symptoms. He presented with congestive heart failure, due to myocarditis and severe left ventricular systolic impairment associated with severe pulmonary hypertension. Serum protein electrophoresis revealed oligoclonal hypergammaglobulinemia. The auto-immune work-up was positive, with anti-nuclear antibodies with a nucleolar, speckled appearance, anti-U1 ribonucleoprotein antibodies, and a positive result for anti-Scl 70 antibodies. Progression of the condition was marked by the disappearance of pulmonary hypertension and an improvement in ventricular kinetics and ejection fraction, which rose from 15% to 52% after treatment with an anti-endothelin agent combined with an immunosuppressant and corticosteroid therapy. In a country with few diagnostic resources, therapeutic testing could be useful in improving the condition of patients.