Immune checkpoint inhibitor–related myocarditis in a patient with hepatocellular carcinoma: a case report
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By
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Yuqiang Zhou
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Zhiliang Zhang
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Shasha Liu
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Jiang Nan
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Zhuoli Zhang
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Zixian Chen
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June 3, 2026
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Clinical Scorecard: Myocarditis Induced by Immune Checkpoint Inhibitors in a Patient with Hepatocellular Carcinoma: A Case Study
At a Glance
| Category | Detail |
|---|
| Condition | Myocarditis induced by immune checkpoint inhibitors |
| Key Mechanisms | Immune-related adverse events (irAEs) associated with PD-1 inhibitors |
| Target Population | Patients with hepatocellular carcinoma (HCC) receiving immune checkpoint inhibitors |
| Care Setting | Oncology and cardiology settings |
Key Highlights
- Myocarditis is a rare but life-threatening irAE occurring in 0.04%–1.14% of patients treated with ICIs.
- Diagnosis confirmed through cardiac magnetic resonance (CMR) and endomyocardial biopsy (EMB).
- Management included high-dose corticosteroids, leading to significant clinical improvement.
Guideline-Based Recommendations
Diagnosis
- Utilize multimodal evaluation including cardiac biomarkers, ECG, echocardiography, and CMR for early detection.
Management
- Initiate treatment with high-dose intravenous corticosteroids for ICI-related myocarditis.
Monitoring & Follow-up
- Monitor cardiac biomarkers and ECG changes during and after ICI therapy.
Risks
- High mortality rate of 25%–50% associated with ICI-related myocarditis.
Patient & Prescribing Data
56-year-old man with hepatitis B-related cirrhosis and HCC.
Developed myocarditis after two cycles of PD-1 inhibitor sintilimab.
Clinical Best Practices
- Perform endomyocardial biopsy in suspected cases of ICI-related myocarditis to confirm diagnosis.
- Consider the patient's clinical history and temporal relationship with ICI therapy when diagnosing myocarditis.
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