Unanticipated Myocarditis in a Surgical Patient Treated With Pembrolizumab: A Case Report

A A Pract. 2020 Apr;14(6):e01177. doi: 10.1213/XAA.0000000000001177.


We report a case of fatal immune checkpoint inhibitor (ICI)-associated myocarditis in a 77-year-old man with metastatic non-small cell lung cancer (NSCLC) who presented for mediport placement at our outpatient surgical center. He denied any cardiac complaints and had a previously normal electrocardiogram (EKG) off treatment. Intraoperatively and postoperatively, he displayed cardiac rhythm abnormalities. The patient was then transferred to a tertiary facility, where he expired within 48 hours. As cancer immunotherapy becomes increasingly prominent, ICI-associated myocarditis should be considered a potentially critical contributor to perioperative cardiac morbidity and mortality.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Immunological* / adverse effects
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Humans
  • Lung Neoplasms* / drug therapy
  • Male
  • Myocarditis* / chemically induced
  • Myocarditis* / drug therapy


  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Immunological
  • pembrolizumab