Muscle pathology – Patient stable
October 17, 2026Muscle pathology – Patient stable – Severe No
October 29, 2026Myocarditis algorithm – Stable patient - Severe - Yes
Severe definitive myocarditis
Treat immediately
- Telemetry/ICU + urgent specialist input
- Permanently stop ICI
- Prednisone 1–2 mg/kg within 24 h
- Reassess Troponin levels after +/- 12, 24 and 36h
- Consider ruxolitinib or MMF
No response at 48 h: pulse steroids ± abatacept/ruxolitinib
Slow taper if improving
Severe possible myocarditis
Treat rapidly and reassess diagnosis
- Consider telemetry/ICU
- Withhold ICI pending diagnosis
- Consider prednisone 1–2 mg/kg if no alternative diagnosis
- Reassess Troponin levels after +/- 12, 24 and 36h
- Consider ruxolitinib or MMF
No response at 48 h: reassess diagnosis before escalading to 2mg/kg prednisone and/or add ruxolitinib or MMF
Slow taper if improving