Digital Divide in Telemedicine Services: Who Gets Left Behind?

Immunotherapies, particularly immune checkpoint inhibitors (ICIs), have revolutionized the treatment of various malignant tumors by reactivating antitumor immune responses.However, excessive activation of the immune system can trigger immunemediated adverse events, among which cardiac toxicities are included.Although rare, these complications which encompass myocarditis, pericarditis, arrhythmias, and heart failure carry high morbidity and mortality when not diagnosed and managed promptly.Immune-mediated myocarditis, though reported in less than 1% of patients treated with ICIs, has a mortality rate exceeding 50% in severe cases, underscoring the need for continuous monitoring and multidisciplinary management protocols.Various biomolecular and imaging markers have been evaluated for early diagnosis, including B-type natriuretic peptide (BNP), cardiac troponins, and cardiac magnetic resonance imaging with late gadolinium enhancement.Management is based on temporary or permanent discontinuation of immunotherapy combined with high-dose corticosteroids; additional therapies such as azathioprine and intravenous immunoglobulin may be instituted in refractory cases.Protocols for reintroducing ICIs after severe cardiac toxicity remain controversial and require case-by-case assessment.This review critically examines current evidence on the epidemiology, pathophysiology, diagnosis, and management of immunotherapy-related cardiac toxicities, proposing guidelines for early identification and therapeutic strategies aimed at reducing morbidity and mortality associated with these adverse events.