Concomitant myopericarditis and takotsubo syndrome following immune checkpoint inhibitor therapy.
BMJ Case Rep
; 13(9)2020 Sep 02.
Article
em En
| MEDLINE
| ID: mdl-32878855
ABSTRACT
A 62-year-old man with metastatic hepatocellular carcinoma presented with ST elevation myocardial infarction had received one dose of nivolumab 3 weeks prior. Cardiac catheterisation was negative for obstructive coronary artery disease. He was transferred to the cardiac intensive care unit due to ventricular arrhythmias and markedly elevated troponin T levels. Transthoracic echocardiogram showed severely depressed left ventricular ejection fraction of 18% (normal 55%-70%) with mid and apical ballooning consistent with takotsubo syndrome (TTS). Intravenous glucocorticoids were administered due to suspicion for superimposed myocarditis. Cardiac MRI 3 days later showed mid-myocardial and subepicardial delayed enhancement in the inferior and lateral walls as well as apex indicative of myopericarditis. He clinically improved on steroids and was discharged with outpatient follow-up. This case highlights major cardiac complications that may arise with immune checkpoint inhibitor therapy. In addition, it emphasises the importance of assessing for concomitant myocarditis even when initial imaging suggests TTS.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pericardite
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Cardiomiopatia de Takotsubo
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Infarto do Miocárdio com Supradesnível do Segmento ST
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Inibidores de Checkpoint Imunológico
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Miocardite
Limite:
Humans
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Male
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Middle aged
Idioma:
En
Revista:
BMJ Case Rep
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos