Immune checkpoint inhibitor-induced myopericarditis

Area of Science:

• Cardiology
• Oncology
• Immunology

Background:

• Metastatic rectal adenocarcinoma is a complex malignancy.
• Immune checkpoint inhibitors (ICIs) like pembrolizumab are used in cancer treatment.
• ICI therapy can rarely lead to immune-related adverse events affecting various organs.

Observation:

• A patient on pembrolizumab presented with abdominal pain, followed by chest pain.
• Elevated troponin levels and echocardiogram findings suggested myocardial injury.
• Cardiac MRI revealed myocardial damage and pericarditis, excluding coronary artery disease.

Findings:

• The case demonstrates immune checkpoint inhibitor-induced myocarditis and pericarditis.
• Diagnosis was confirmed through a combination of clinical presentation, cardiac biomarkers, and advanced imaging.
• Steroid therapy led to a significant clinical improvement.

Implications:

• ICI-induced myocarditis and pericarditis are rare but potentially fatal complications.
• A multidisciplinary approach is essential for accurate diagnosis and timely management.
• Early detection and intervention are critical to improve patient outcomes and survival rates.