[Cardio-oncology in intensive care medicine : Management of therapy-associated cardiac dysfunction, immune checkpoint inhibitor-associated myocarditis, and arrhythmias].

backgroundAdvances in oncology and demographic changes are leading to a growing number of critically ill patients with malignancies. In addition to classical indications for intensive care, cardiovascular complications increasingly occur as therapy- or tumor-associated organ manifestations.

objectiveTo describe typical clinical presentations and a pragmatic diagnostic and therapeutic approach, exemplified by acute cardiac dysfunction, arrhythmias, and immune checkpoint inhibitor (ICI)-associated myocarditis.

methodsNarrative synthesis of current guidelines, consensus statements, and selected studies with a focus on applicability in the intensive care setting.

resultsCommon complications include acute cardiac dysfunction, thromboembolic events, and arrhythmias. ICI-associated myocarditis is less frequent but highly lethal and requires early recognition and treatment. Early identification based on typical clinical warning signs, structured diagnostics (biomarkers, ECG, echocardiography), consistent trigger control (e.g., sepsis, anemia, electrolyte disturbances, drug interactions), and risk-adapted, guideline-based interdisciplinary management are crucial for patient outcomes.

conclusionCardio-oncological critical care benefits from standardized pathways, close monitoring, and early goal setting to reduce complications and enable the safe continuation of curative or life-prolonging cancer therapies whenever possible.