Double Trouble: Myocarditis After Dual Checkpoint Inhibitors

Immune checkpoint inhibitor (ICI)-associated myocarditis is a serious immune-related adverse event with a variable clinical presentation and challenging management.We present a case of fulminant ICI-associated myocarditis complicated by complete heart block, decompensated heart failure, and cardiogenic shock, followed by neuromuscular toxicity with myasthenia gravis overlap.Our case highlights the clinical challenges of ICI myocarditis and a possible treatment strategy involving high-dose steroids and T-cell antimetabolites.