A Rare Cause of Dyspnea in SARS-CoV-2 Emergency: A Case of Cardiac Tamponade During Pembrolizumab Immunotherapy for Lung Cancer |Biomedgrid

Pembrolizumab - an immune checkpoint inhibitor (ICI) - is commonly used for immunotherapy in patients with lung cancer. Unlike other anti-cancer agents, ICIs can produce specific immune-related adverse events that can affect cardiovascular system in approximately 1% of cases. Cardiovascular complications include more often heart failure, dilated cardiomyopathy, myocarditis, and conduction abnormalities. Pericardial effusion and cardiac tamponade after ICI therapy are rare and due to acute lymphocytic pericarditis. In patients with cardiac tamponade, clinical presentation can be featured by fever and acute dyspnea, potentially mimicking acute respiratory disease such as SARS-CoV-2 infection and complicating their management. We report the first case of cardiac tamponade due to pembrolizumab in a patient with lung adenocarcinoma admitted to the emergency department during the COVID-19 pandemic.