Keeping Immune Checkpoint Inhibitor Myocarditis in Check: Advanced Circulatory Mechanical Support as a Bridge to Recovery
Ashley Stein-Merlob, Jeffrey J. Hsu, Bradley Colton, Christopher Berg, Allison Ferreira, Megan M. Price, Zev A. Wainberg, A. Baas, Mario C. Deng, Rushi V. Parikh, Eric H. Yang
Abstract
Immune checkpoint inhibitor (ICI)-associated myocarditis is a rare, potentially life-threatening complication of immunotherapy. We report a case of a 60-year-old female with a history of colorectal cancer treated with nivolumab immunotherapy who presented with new cardiomyopathy complicated by cardiogenic shock and ventricular arrhythmias. Treatment of ICI-associated myocarditis requires aggressive immunosuppression and supportive therapy. In this case, the patient required advanced mechanical circulatory support as a bridge to recovery. This case highlights the complexity of diagnosis, haemodynamic management, and treatment of fulminant ICI myocarditis.