Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website http://www.cardiologyres.org

Case Report

Volume 10, Number 2, April 2019, pages 120-123

A Case of Acute Heart Failure due to Immune Checkpoint Blocker Nivolumab

Figures

Figure 1.
Figure 1. ECG on July 27, 2018: left axis deviation, sinus tachycardia and low voltage.
Figure 2.
Figure 2. Echocardiogram obtained during hospital admission showing low ejection fraction.
Figure 3.
Figure 3. (a) Echocardiogram done on June 14, 2018 showing normal ejection fraction by biplane. (b, c) Echocardiogram done on June 14, 2018.
Figure 4.
Figure 4. CT chest showing bilateral pleural effusion.

Table

Table 1. Two-Dimensional Transthoracic Echogardiogram (TTE) Report on July 21, 2018
 
PericardiumModerate pericardial effusion
In comparison to the previous study dated June 14, 2018, there is significant change noted (moderate pericardial effusion is seen and LVEF is severely reduced at < 20%).
Left ventricleSeverely reduced systolic function, ejection fraction estimated at less than 20%, unable to assess left ventricle diastolic function (tachycardia), mild asymmetric hypertrophy
Right ventricleCavity mildly dilated
Right atriumCavity mildly dilated
Inferior vena cavaDilated (> 2.1 cm) with less than 50% respiratory collapse with an estimated right atrial pressure of 15 mm Hg
Mitral valveMild to moderate regurgitation on color-flow PW Doppler
Tricuspid valveModerate to severe regurgitation on color-flow PW Doppler
Aortic valveThe aortic valve is sclerotic without reduced excursion, no stenosis, trace regurgitation on color-flow PW Doppler
Pulmonic valveThe pulmonic valve was not well visualized, trace regurgitation on color-flow PW Doppler