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irAE Myocarditis Screening — SCE Medical Oncology MCQ

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HardMelanoma & SkinirAE Myocarditis ScreeningSCE Medical Oncology

Three days after combination immune-checkpoint blockade, a patient has chest pain, new complete heart block, rising troponin and unobstructed coronary arteries. ICI myocarditis is considered likely. Which corticosteroid regimen best matches ESC guidance?

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Correct answer: C — Use intravenous methylprednisolone 500–1,000 mg daily for 3–5 days once myocarditis is likely

Likely ICI myocarditis with conduction disease is a time-critical emergency. ESC guidance supports early IV methylprednisolone 500–1,000 mg daily for three to five days; treatment should not wait for exhaustive imaging or biopsy confirmation when clinical suspicion is high. Low-dose oral regimens are inadequate and immunotherapy is stopped.

Reference: 2022 ESC cardio-oncology guideline. https://academic.oup.com/ehjcimaging/article/23/10/e333/6675075