Year: 2026
Type: article
Study design: Case Report
Abstract: A 64-year-old male with coronary artery disease, hypertension, hyperlipidemia, obstructive sleep apnea, and right ureteral urothelial carcinoma presented with chest pain, neck weakness, and myalgias after his first cycle of pembrolizumab and enfortumab vedotin. He developed a non-ST-segment elevation myocardial infarction (NSTEMI) alongside suspected immune checkpoint inhibitor (ICI)-associated myocarditis and myositis. Initial tests showed elevated troponin at 568 ng/L, creatinine phosphokinase (CPK) at 3,332 U/L, and transaminases. ECG revealed anterolateral ST-segment depression and left anterior fascicular block. Cardiac catheterization confirmed 90% mid-left anterior descending (LAD) artery stenosis, treated with a drug-eluting stent, and endomyocardial biopsy verified focal moderate lymphocytic myocarditis with myocyte necrosis. Treatment with high-dose methylprednisolone and intravenous immunoglobulin led to improvement in symptoms, biomarkers, and cardiac function. He was discharged on prednisone taper, dual antiplatelet therapy, anticoagulation, and prophylaxis, with outpatient follow-up arranged.
Source: Cureus
Authors: Chirag Lodha, Eric J Basile, Corbin C Wright
Institution: University of South Florida
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7161977755