Open Access
Table 2
Overview of common immune therapy related cardiovascular toxicities [2, 4, 17–27].
| Cardiotoxicity Type | Common symptoms | Workup and evaluation | Treatment |
|---|---|---|---|
| Myocarditis | Shortness of breath, palpitations, edema, fatigue, myalgias, low blood pressure, chest pain, asymptomatic | Elevated BNP, NT-proBNP, troponins | High-dose corticosteroids (methylprednisolone, prednisone) Immunosuppressive therapies in steroid refractory cases (alemtuzumab, abatacept, intravenous immunoglobin, mycophenolate) |
| ECG, TTE, CMR endomyocardial biopsy | |||
| Pericarditis | Shortness of breath (most common) chest pain, hypotension, fever, light-headedness | Troponin typically not elevated | High-dose corticosteroids Colchicine NSAIDs Pericardiocentesis, pericardial window |
| ECG, TTE, CT, CMR | |||
| Arrhythmias | Palpitations, shortness of breath, chest pain/ discomfort, dizziness, fainting, fatigue | ECG | High-dose corticosteroids Antiarrhythmics (beta-blockers, amiodarone, calcium channel blockers) Pacemaker as indicated |
| Cardiomyopathy | Shortness of breath, edema, fluid overload, palpitations, chest pain | Elevated troponin and NT-proBNP | Corticosteroids Diuretics Anticoagulants |
| TTE, ECG, PET/CT | |||
| Myocardial infarction | Chest pain, shortness of breath, diaphoresis, dizziness/lightheadedness, edema, nausea, vomiting, fatigue, tooth pain, jaw pain, neck pain, left arm pain | Elevated troponin | Cardiac catheterization Supportive measures (i.e.: nitroglycerin, anticoagulants, statins) |
| ECG | |||
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