In some situations, anti-PD-1/PDL-1 drugs lead to left cardiac dysfunction without evidence of myocarditis and present as a functional impairment called non-inflammatory left ventricular dysfunction, including dilated cardiomyopathy, Takotsubo syndrome, and unobstructed coronary arteries with high BNP and long-QT syndrome [78], [79]. The gene discussed is CD274; the disease is Tako-tsubo cardiomyopathy.