Immune checkpoint inhibitor myocarditis with complete heart block: a case series
نویسندگان
چکیده
Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Immune checkpoint inhibitor (ICI) myocarditis is a life-threatening condition characterized by lymphocytic myocardial infiltration[1]. Complete heart block (CHB) occurs in 15% cases and often fatal[2-4]. The nature optimal management this often-malignant poorly understood[5]. Purpose This case series assesses prognostic factors associated with survival at 90 days among people ICI CHB. Methods electronic patient record system was used to identify patients admitted myocarditis. A two-physician review assess the presence ICI-associated Wilcoxon rank sum Spearman’s correlation were for categorical quantitative variables respectively. Data analysed using STATA/IC 16.1. primary outcome person-day after presenting symptom onset. Results Six included final analysis. Mean 47 person days. All had metastatic disease presented 15 32 first infusion. muscle weakness. Other common self-symptoms shortness breath (4), blurred vision double (3), collapse leg swelling (1). Proximal myopathy (2), fatigable (1), ptosis peripheral oedema (1) present on examination. Raised troponin T white blood cell count (WBC) 90-day (see Table 1). Nt-pro BNP, AST, CK levels raised all patients. Two tested anti-striated antibody titres, both strongly positive. Increase QRS duration compared baseline ECG lower Only one CHB admission. Steroid dose, IVIG, plasmapheresis weren’t survival. One declined device therapy. permanent pacemaker (PPM) insertion transvenous (TVP). Both died within 2 weeks. Three underwent (TVP) followed PPM (table 2). three eventually 100 received isoproterenol immunosuppression as bridge survived. managed initially TVP but subsequently insertion. removal resulted recurrence, they shortly discharge. therapy while receiving comfort care. Lead malfunction frequent. experienced bradycardia arrest failure lead capture, another dislodgement. Conclusion secondary fatal. It should be considered symptoms myositis, increased duration. Despite small sample size, study identifies several which can guide physicians decision-making. Larger studies are needed better understand role population.
منابع مشابه
Complete heart block in mumps myocarditis.
A patient with mumps myocarditis is reported. The onset of mumps was typical, with fever and parotid swelling followed by raised virus antibody titres. Atrioventricular block occurred and persisted despite steroid treatment for two weeks. He had an Adams-Stokes attack. A permanent pacemaker was implanted and, thereafter, the patient remained dependent upon it. The published material on conducti...
متن کاملHyperkalemia-induced complete heart block
Background: Potassium, as an extracellular ion, plays an important role in the electrophysiologic function of the myocardium and any change in extracellular concentration of this ion might have a marked impression upon myocyte electrophysiologic gain. High serum potassium levels are thought to impair pulse conduction in Purkinje fibers and ventricles more than that in the Atrio...
متن کاملComplete Congenital Heart Block in a Neonatal Lupus Erythematosus Associated with Pulmonary Involvement without Pacemaker Implantation: A Case Report
Background: Neonatal lupus erythematosus is an uncommon disease. Congenital complete heart block (CCHB) usually happens in neonates with maternal systemic lupus erythematosus. The most prevalent presentation of CCHBis bradycardiathatcanbediagnosed through an electrocardiogram. Case report: Here in, we present the case of a full-term male neonate with gestational age of 37 weeks and birth weigh...
متن کاملComplete atrioventricular block associated with toxoplasma myocarditis.
Myocarditis has been described during and after a wide variety of infectious agents: viral, rickettsial, bacterial, protozoal, and metazoal diseases may cause cardiac inflammation. We report a case of toxoplasma myocarditis in a young healthy man.
متن کاملSuccessful electrical pacing for complete heart block complicating diphtheritic myocarditis.
A case of severe diphtheria complicated by myocarditis and neurorespiratory paralysis is reported. The myocarditis manifested with severe conduction disturbances including left bundle-branch block and high grade second degree atrioventricular block leading to Adams-Stokes attacks. Temporary transvenous electrical pacing for.3 days was successful in the management of this complication, but posit...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
ژورنال
عنوان ژورنال: Europace
سال: 2023
ISSN: ['1099-5129', '1532-2092']
DOI: https://doi.org/10.1093/europace/euad122.246