Compagnone Miriam, Dall'Ara Gianni, Bergamaschi Luca, Gardini Elisa, Pizzi Carmine, Galvani Marcello
Cardiology Unit, Morgagni Pierantoni Hospital Forlì, Italy.
Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
JACC Case Rep. 2024 Nov 6;29(21):102663. doi: 10.1016/j.jaccas.2024.102663.
We present a case of ventricular thrombosis occurring in myocarditis due to immune checkpoint inhibitors (ICIs), presenting as myocardial infarction and complicated by refractory cardiogenic shock. Although myocarditis is a well-known adverse event of ICIs, intraventricular thrombus formation in this context is extremely rare. Differential diagnosis between ventricular thrombosis and tumoral mass can be challenging, especially in oncologic patients. Careful clinical evaluation and multimodality imaging are essential for correct diagnosis. The incidence of ICI cardiovascular complications is relatively low, but associated mortality is alarmingly high. Therefore, we intend to discuss the difficulties in managing these life-threatening cardiovascular complications.
我们报告一例因免疫检查点抑制剂（ICI）导致心肌炎并发心室血栓形成的病例，该病例表现为心肌梗死并伴有难治性心源性休克。虽然心肌炎是ICI已知的不良事件，但在这种情况下发生心室内血栓形成极为罕见。心室血栓与肿瘤性肿块的鉴别诊断可能具有挑战性，尤其是在肿瘤患者中。仔细的临床评估和多模态成像对于正确诊断至关重要。ICI心血管并发症的发生率相对较低，但相关死亡率却高得惊人。因此，我们打算讨论处理这些危及生命的心血管并发症时所面临的困难。
