Hydroxychloroquine Myocardial Toxicity in a Patient with Systemic Lupus Erythematosus

Hydroxychloroquine is an antimalarial drug used in many rheumatologic and systemic diseases. Although considered by clinicians to be relatively safe, serious side effects have been documented (retinotoxicity, neuromyotoxicity and cardiotoxicity). We present the case of a 41-year-old woman with systemic lupus erythematosus (SLE) who presented at our institution with acute heart failure after taking hydroxychloroquine for a period of 3 months. An endomyocardial biopsy ruled out myocarditis related to systemic lupus erythematosus but demonstrated pathological changes related to hydroxychloroquine toxicity. It is exceptional to observe such cardiac toxicity after such a low cumulative dose (16 grams). The potential severity and reversibility of this complication underscores the importance of a high level of suspicion and timely diagnosis.

Simultaneous Acute Pulmonary Embolism and Isolated Septal Myocardial Infarction in a Young Patient

We report here the case of a young patient with a simultaneous isolated septal myocardial infarction (MI) and pulmonary embolism (PE). The aim was to describe a rare clinical entity and to explain why these two pathologies were present at the same time in a young patient.
 A review of literature was established. An interventional cardiologist, an interventional radiologist and a lung specialist were consulted. The diagnostic workup revealed only heterozygous Factor Leiden V mutation. This presentation was probably fortuitous, but worth reporting to our opinion.