The methotrexate (MTX) is an antimetabolite, whose dosages vary according to indication. It is used in the treatment of tumoral pathologies, as acute lymphoblastic leukaemias and, in rheumatology, in the rheumatoid polyarthritis (RP) and other chronic inflammatory rheumatisms The methotrexate belongs to the group of antifolates: it inhibits purine and pyrimidine synthesis, which accounts for its efficacy in the therapy of cancer as well as for some of its toxicities. Relative or absolute overdoses in low-dose methotrexate treatments for non-oncological diseases are regularly reported, either in isolated cases or in small series. The bone marrow toxicity with thrombocytopenia and leuconeutropenia is most often the first sign of general involvement. The cardiotoxicity of methotrexate is very rare, in this article we report the observation of pancytopenia associated with cardiotoxicity in a woman treated for RA, for whom the etiological investigation revealed inadvertent methotrexate intoxication by mistake of dosage.

We report the case of a myxoma of the left atrium in a patient aged 73, who presented for lipothymic discomfort. Echocardiography was used to diagnose an hypermobile myxoma attached to the interauricular septum with haemodynamic impact. Support was limited because of the very small technical platform.

Conduction disturbances complicating acute myocardial infarction with persistent ST segment elevation are common, especially those of high degree in previous myocardial infarctions. Do these complications occur in the acute phase, before revascularization, with a poor prognosis immediately justifying myocardial reperfusion as well as the placement of an electro systolic training lead. However, their absence before revascularization to occur in post percutaneous reperfusion by angioplasty with placement of an active stent on the culprit artery, with an increase in the ST elevation, is unprecedented and raises as many questions as possible whereas the Stent in place remains permeable. We report the case of a patient presenting, initially, a 3rd degree atrioventricular block after percutaneous revascularization of an ST + extended anteriorly by angioplasty and placement of an active stent on the anterior interventricular coronary artery permeable after a second post-critical coronary angiography.