SHM Converge Scientific Abstract ePoster Gallery-A Case of Tyrosine Kinase Inhibitor Induced Myocarditis

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This case report describes a 75-year-old woman with chronic myeloid leukemia (CML) treated with dasatinib, a tyrosine kinase inhibitor (TKI), who developed recurrent chest pain and repeated episodes of elevated high-sensitivity troponin. Her initial workup showed normal biventricular systolic function on echocardiography, mild non-obstructive coronary artery disease on left heart catheterization, and no clear ischemic cause for her symptoms. Over the next five months, she had multiple similar presentations.<br /><br />On her fifth presentation, cardiac MRI showed patchy intramyocardial and epicardial late gadolinium enhancement in a pattern consistent with myocarditis. One month later, she again presented with chest pain and markedly elevated troponin, but repeat coronary evaluation again showed no significant obstructive disease. Dasatinib was stopped because of concern for TKI-induced myocarditis, and she was treated with prednisone. After discontinuing dasatinib, she remained free of chest pain.<br /><br />The report emphasizes that TKIs have greatly improved survival in CML, but they can cause rare yet serious cardiovascular toxicities. Dasatinib is more commonly linked to edema and pulmonary hypertension, while myocarditis is an unusual and sparsely reported adverse effect. The authors highlight the importance of considering TKI-induced myocarditis in patients on these agents who present with chest pain, troponin elevation, and nonobstructive coronary findings. They also stress the need for multidisciplinary management and further research to better understand the incidence and mechanisms of this complication.

Asset Subtitle

Emily E. Weeden

Meta Tag

Author List Emily E. Weeden, Francisco Aguilar, Jefferson T Baer

Category Clinical Vignettes

Concept Tyrosine Kinase Inhibitor

Concept Myocarditis

Concept Cardiovascular Adverse Effect

Concept Magnetic Resonance Imaging

Concept Late Gadolinium Enhancement

Distinguished Non-Finalist

Presenter Organization Emory University School of Medicine, Department of Anesthesiology

Presenting Author Emily E. Weeden

Track Adult

Keywords

chronic myeloid leukemia

dasatinib

tyrosine kinase inhibitor

myocarditis

chest pain

troponin elevation

cardiac MRI

non-obstructive coronary artery disease

cardiotoxicity

prednisone

Tyrosine Kinase Inhibitor

Myocarditis

Cardiovascular Adverse Effect

Magnetic Resonance Imaging

Late Gadolinium Enhancement