Left Ventricular Thrombosis in Immune Checkpoint Inhibitor Myocarditis Mimicking ST-Segment Elevation Myocardial Infarction

We present a case of ventricular thrombosis occurring in myocarditis due to immune checkpoint inhibitors (ICIs), presenting as myocardial infarction and complicated by refractory cardiogenic shock. Although myocarditis is a well-known adverse event of ICIs, intraventricular thrombus formation in this context is extremely rare. Differential diagnosis between ventricular thrombosis and tumoral mass can be challenging, especially in oncologic patients. Careful clinical evaluation and multimodality imaging are essential for correct diagnosis. The incidence of ICI cardiovascular complications is relatively low, but associated mortality is alarmingly high. Therefore, we intend to discuss the difficulties in managing these life-threatening cardiovascular complications.