{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:57:10Z","timestamp":1785761830769,"version":"3.56.0"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Immune checkpoint inhibitors (ICIs) are effective antineoplastic agents but can cause adverse effects in many organ systems. Cardiovascular toxicities include arrhythmias, myocarditis, heart failure, takotsubo syndrome, pericarditis, coronary artery disease, and vasculitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 66-year-old woman with Stage 3C2 endometrial carcinoma presented for her second cycle of pembrolizumab, carboplatin, and paclitaxel. She subsequently suffered cardiac arrest and was brought to the emergency department. Spontaneous circulation returned following resuscitation, but she was haemodynamically unstable. An electrocardiogram revealed complete heart block. Initial management included intubation, vasopressor support, and transcutaneous pacing before transfer to the catheterization lab. Coronary angiography revealed no coronary artery disease. Right heart catheterization confirmed severe cardiogenic shock despite inotropic support and a temporary transvenous pacemaker in place. A micro-axial flow pump (Impella CP) was implanted for deteriorating cardiogenic shock. She was treated with high-dose corticosteroids (dexamethasone 190\u2005mg i.v.) for suspected ICI-associated myocarditis, with significant improvement in cardiac function. The Impella was weaned and removed on Day 5. Cardiac magnetic resonance imaging showed elevated T1 and T2 signal intensities, consistent with the 2018 Lake Louise Criteria for myocarditis. The complete heart block was resolved, but a leadless pacemaker was implanted due to pre-existing conduction abnormalities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Early recognition of ICI-associated myocarditis can be achieved with biochemical testing, electrocardiography, imaging, and expedited investigation of alternative causes for cardiac decompensation. Our case demonstrates that temporary left ventricular assist devices can support cardiac output for patients in cardiogenic shock due to ICI-associated myocarditis, allowing for recovery following high-dose corticosteroids.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae665","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T12:39:31Z","timestamp":1734093571000},"source":"Crossref","is-referenced-by-count":3,"title":["Fulminant immune checkpoint inhibitor-associated myocarditis bridged to recovery with a temporary left ventricular assist device: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4030-5739","authenticated-orcid":false,"given":"Quinn","family":"Mallery","sequence":"first","affiliation":[{"name":"Cardiology Department, Loyola University Medical Center , 2160 S 1st Ave, Maywood, IL 60153-3328 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Walsh","sequence":"additional","affiliation":[{"name":"Cardiology Department, Loyola University Medical Center , 2160 S 1st Ave, Maywood, IL 60153-3328 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Pelka","sequence":"additional","affiliation":[{"name":"Cardiology Department, Loyola University Medical Center , 2160 S 1st Ave, Maywood, IL 60153-3328 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1069-2624","authenticated-orcid":false,"given":"Ivo","family":"Genev","sequence":"additional","affiliation":[{"name":"Cardiology Department, Loyola University Medical Center , 2160 S 1st Ave, Maywood, IL 60153-3328 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0144-1804","authenticated-orcid":false,"given":"Amir","family":"Darki","sequence":"additional","affiliation":[{"name":"Cardiology Department, Loyola University Medical Center , 2160 S 1st Ave, Maywood, IL 60153-3328 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,13]]},"reference":[{"key":"2025012113065362300_ytae665-B1","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.1161\/CIRCULATIONAHA.117.030571","article-title":"Clinical features, management, and outcomes of immune checkpoint inhibitor-related cardiotoxicity","volume":"136","author":"Escudier","year":"2017","journal-title":"Circulation"},{"key":"2025012113065362300_ytae665-B2","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1016\/j.jacc.2018.02.037","article-title":"Myocarditis in patients treated with immune checkpoint inhibitors","volume":"71","author":"Mahmood","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2025012113065362300_ytae665-B3","doi-asserted-by":"crossref","first-page":"4301","DOI":"10.1002\/ehf2.13545","article-title":"Keeping immune checkpoint inhibitor myocarditis in check: advanced circulatory mechanical support as a bridge to recovery","volume":"8","author":"Stein-Merlob","year":"2021","journal-title":"ESC Hear Fail"},{"key":"2025012113065362300_ytae665-B4","doi-asserted-by":"crossref","first-page":"3158","DOI":"10.1016\/j.jacc.2018.09.072","article-title":"Cardiovascular magnetic resonance in nonischemic myocardial inflammation: expert recommendations","volume":"72","author":"Ferreira","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2025012113065362300_ytae665-B5","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.4110\/in.2022.22.e2","article-title":"Immune checkpoint inhibitors in 10 years: contribution of basic research and clinical application in cancer immunotherapy","volume":"22","author":"Lee","year":"2022","journal-title":"Immune Netw"},{"key":"2025012113065362300_ytae665-B6","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1161\/CIRCULATIONAHA.118.034497","article-title":"Myocarditis in the setting of cancer therapeutics: proposed case definitions for emerging clinical syndromes in cardio-oncology","volume":"140","author":"Bonaca","year":"2019","journal-title":"Circulation"},{"key":"2025012113065362300_ytae665-B7","doi-asserted-by":"crossref","first-page":"350","DOI":"10.33678\/cor.2023.032","article-title":"2022 ESC guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS)","volume":"65","author":"Pudil","year":"2023","journal-title":"Cor Vasa"}],"container-title":["European Heart Journal - 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