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Myocarditis I: Introduction

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Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...

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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...

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Updated: Dec 28, 2025

Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model

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Immunotherapy-Associated Myocarditis.

Klinicka Onkologie : Casopis Ceske a Slovenske Onkologicke Spolecnosti

|February 21, 2020

Summary

Checkpoint inhibitors, used in cancer immunotherapy, can cause autoimmune diseases and cardiotoxicity. These immune-related adverse events, including myocarditis, require careful patient monitoring during treatment.

Area of Science:

Immunology
Oncology
Cardiology

Background:

Checkpoint inhibitors modulate T-lymphocyte activity, offering cancer treatment benefits.
These immunotherapies can trigger or worsen autoimmune conditions.
Adverse events, including cardiotoxicity, are associated with checkpoint inhibitor therapy.

Purpose of the Study:

To review the impact of checkpoint inhibitors on T-lymphocyte balance.
To discuss the development of autoimmune diseases secondary to checkpoint inhibitor use.
To detail the cardiac adverse events associated with immune checkpoint inhibitors.

Main Methods:

Literature review of studies on checkpoint inhibitors and immune-related adverse events.
Analysis of mechanisms underlying cardiotoxicity induced by anti-CTLA4 and anti-PD-1/PD-L1 therapies.

Keywords:

adverse events cardiotoxicity checkpoint inhibitors immunotherapy myocarditis

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Examination of clinical manifestations and consequences of cardiac damage.

Main Results:

Checkpoint inhibitors can lead to exacerbation or new onset of autoimmunity.
Cardiotoxicity, primarily lymphocytic myocarditis, is a significant adverse event.
Manifestations range from asymptomatic cardiac marker elevation to cardiogenic shock, including pericardial damage and Tako-tsubo cardiomyopathy.

Conclusions:

Immune checkpoint inhibitors, while effective cancer treatments, carry risks of autoimmune complications, particularly cardiotoxicity.
Understanding these risks is crucial for managing patients undergoing immunotherapy.
Vigilant monitoring for cardiac adverse events is essential in patients treated with these agents.