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Keeping immune checkpoint inhibitor myocarditis in check: advanced circulatory mechanical support as a bridge to

Ashley F Stein-Merlob1, Jeffrey J Hsu1,2, Bradley Colton3

  • 1Division of Cardiology, Department of Medicine, University of California, Los Angeles, MD 650 Charles E. Young Dr. South, A2-27 CHS, Los Angeles, CA, 90095, USA.

ESC Heart Failure
|August 14, 2021
PubMed

Insights

Immune checkpoint inhibitor (ICI) myocarditis is a rare but serious immunotherapy side effect. Aggressive treatment, including mechanical support, can lead to recovery in severe cases.

Area of Science:

  • Cardiology
  • Immunology
  • Oncology

Background:

  • Immune checkpoint inhibitors (ICIs) like nivolumab have revolutionized cancer treatment.
  • However, ICIs can cause immune-related adverse events, including myocarditis.

Observation:

  • A 60-year-old female with colorectal cancer developed cardiomyopathy, cardiogenic shock, and ventricular arrhythmias after nivolumab treatment.
  • This presentation indicated fulminant ICI-associated myocarditis.

Findings:

  • The patient required advanced mechanical circulatory support.
  • Aggressive immunosuppression and intensive supportive care were crucial for management.

Implications:

  • This case underscores the critical need for prompt diagnosis and aggressive management of ICI myocarditis.
  • Effective hemodynamic support and immunosuppression are vital for improving outcomes in fulminant cases.

Keywords:
Acute heart failureCardiac assist deviceCardiomyopathyCardiooncologyImmune checkpoint inhibitor myocarditis

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