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Subclinical Myocarditis Troponin — SCE Medical Oncology MCQ

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ModerateImmunotherapy & Targeted TherapySubclinical Myocarditis TroponinSCE Medical Oncology

A 65-year-old man on nivolumab has incidental troponin 50 ng/L (normal <14) on routine bloods. Asymptomatic. ECG normal. What to do?

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Correct answer: E — Investigate — asymptomatic troponin elevation may represent subclinical myocarditis

Subclinical ICI myocarditis: even asymptomatic troponin elevation warrants investigation given 25-50% mortality if untreated. Serial troponin (rising trajectory concerning), ECG, echo, ± cardiac MRI.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer