ArticleJACC. Case reports2026
Coronary Vasospasm and Myopericarditis Presenting as ST-Segment Elevation Myocardial Infarction During Immune Checkpoint Inhibitor Therapy.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundImmune checkpoint inhibitors (ICIs) are associated with rare but potentially fatal immune-related adverse events, including myocarditis, vasculitis, and hypophysitis. CASE SUMMARY: A 53-year-old man with metastatic clear-cell renal cell carcinoma receiving ipilimumab and nivolumab presented with a clinical picture suggestive of acute coronary syndrome. Coronary angiography showed severe triple-vessel disease without a culprit lesion; repeat angiography demonstrated resolution of coronary lesions, consistent with vasospasm. Cardiac magnetic resonance confirmed ICI-associated myocarditis. Concurrent hypophysitis causing secondary adrenal insufficiency was diagnosed. The patient improved with corticosteroids, with full recovery of cardiac function. DISCUSSION: This case illustrates a rare treatable quadrad of immune-related adverse events-coronary vasospasm, myocarditis, pericarditis, and hypophysitis-and highlights coronary vasospasm as a reversible and underrecognized manifestation of ICI-associated myocarditis. TAKE-HOME MESSAGES: Coronary vasospasm can mimic obstructive coronary disease and should be considered in immune checkpoint inhibitor myocarditis. Multisystem immune-related adverse events, including myocarditis, pericarditis, and hypophysitis, may present simultaneously and require prompt multidisciplinary care.
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