Unanticipated Myocarditis in a Surgical Patient Treated With Pembrolizumab: A Case Report.

A&A Practice
Ryan T NierstedtKara M Barnett

Abstract

We report a case of fatal immune checkpoint inhibitor (ICI)-associated myocarditis in a 77-year-old man with metastatic non-small cell lung cancer (NSCLC) who presented for mediport placement at our outpatient surgical center. He denied any cardiac complaints and had a previously normal electrocardiogram (EKG) off treatment. Intraoperatively and postoperatively, he displayed cardiac rhythm abnormalities. The patient was then transferred to a tertiary facility, where he expired within 48 hours. As cancer immunotherapy becomes increasingly prominent, ICI-associated myocarditis should be considered a potentially critical contributor to perioperative cardiac morbidity and mortality.

References

Apr 23, 2015·Journal for Immunotherapy of Cancer·Heinz LäubliAlfred Zippelius
Jul 16, 2015·The New England Journal of Medicine·Mizuki NishinoNikhil H Ramaiya
May 7, 2016·BMC Medicine·Sofia FarkonaIvan M Blasutig
Oct 19, 2017·Japanese Journal of Clinical Oncology·Kazuko TajiriIkuo Sekine
Mar 24, 2018·Journal of the American College of Cardiology·Syed S MahmoodTomas G Neilan
May 29, 2018·The Oncologist·Tomas G NeilanUNKNOWN Checkpoint Inhibitor Safety Working Group
Oct 26, 2018·Circulation·Céline AnquetilYves Allenbach
Jun 9, 2019·Current Treatment Options in Cardiovascular Medicine·Lili ZhangTomas G Neilan

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