# Immune-related myocarditis

Source: https://onco.cc/terms/myocarditis/  
OnCo record `myocarditis` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Rare but frequently fatal inflammation of the heart muscle triggered by checkpoint inhibitors, usually in the first two months. It often comes with muscle and nerve-muscle inflammation, and needs urgent high-dose steroids.

## Summary

Occurs in about 1% of patients (more with combination CTLA-4 plus PD-1 and with some other combinations) with mortality of 25-50%; presents with chest pain, breathlessness, arrhythmia or heart block, often alongside myositis and myasthenia (the 'triad'). Diagnosis rests on troponin, ECG, echocardiography, cardiac MRI and biopsy; treatment is immediate methylprednisolone with abatacept, mycophenolate or ruxolitinib for steroid-refractory cases, and the drug is permanently stopped. Baseline and early troponin monitoring is debated. Distinct from anthracycline and trastuzumab cardiomyopathy, which damage the heart without inflammation.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: immune myocarditis; checkpoint myocarditis; myocarditis; immune-mediated myocarditis; troponin; troponin monitoring; myositis; myasthenia; myasthenia gravis; immune-related myositis

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Myocarditis
- Wikipedia: https://en.wikipedia.org/wiki/Myocarditis

## Connected records

- terms: [Cardiotoxicity (LVEF decline, cardiomyopathy)](https://onco.cc/terms/cardiotoxicity/), [Immune-related adverse events (irAEs)](https://onco.cc/terms/irae/), [Immune-related endocrinopathies (thyroiditis, hypophysitis)](https://onco.cc/terms/immune-endocrinopathy/)
- fronts: [Immunotherapy](https://onco.cc/fronts/immunotherapy/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Cardio-oncology](https://onco.cc/technologies/cardio-oncology/), [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/), [Troponin and natriuretic peptide monitoring during cancer treatment](https://onco.cc/technologies/cardiac-biomarker-monitoring/)

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JSON: https://onco.cc/api/v1/entities/myocarditis.json