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Case Reports
. 2020 Apr;14(6):e01177.
doi: 10.1213/XAA.0000000000001177.

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

Ryan T Nierstedt  1   2 , Rubaya Yeahia  2   3 , Kara M Barnett  2
Affiliations
Case Reports

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

Ryan T Nierstedt et al. A A Pract. 2020 Apr.

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.

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Conflict of interest statement

Conflicts of interest: None

Figures

Figure 1.
Figure 1.
Preoperative electrocardiogram (EKG) from 3 months prior displaying normal sinus rhythm
Figure 2.
Figure 2.
Post-anesthesia care unit (PACU) EKG displaying fusion beats and intermittent right bundle branch block
See this image and copyright information in PMC

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