Methotrexate-linked ventricular arrhythmias.
A 36-year-old male, who 1 year previously had survived a large anterior myocardial infarction, followed by cardiac arrest, was treated a few months for psoriasis with oral methotrexate, at single weekly oral doses of up to 10 mg, when he had to be hospitalized due to anginal pain and palpitation. Repeated 24-hour electrocardiogram recordings revealed ventricular ectopy up to 580 premature beats per hour. The ventricular premature beats were almost completely abolished after a few days' discontinuation of methotrexate therapy but recurred a few hours after an attempt to restart it had been made. A coronary angiogram showed only minimal wall abnormalities. Electrophysiological testing and endomyocardial biopsy were normal.
Kettunen
R
R
Department of Internal Medicine, Oulu University Central Hospital, Finland.
Huikuri
H V
HV
Oikarinen
A
A
Takkunen
J T
JT
D000284:Administration, Oral; D000328:Adult; D000787:Angina Pectoris / Q000139:chemically induced; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D001706:Biopsy; D017023:Coronary Angiography; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015716:Electrocardiography, Ambulatory; D004699:Endocardium / Q000473:pathology; D006323:Heart Arrest / Q000503:physiopathology; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D009203:Myocardial Infarction / Q000503:physiopathology; D011565:Psoriasis / Q000188:drug therapy; D012008:Recurrence; D018879:Ventricular Premature Complexes / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology
D003879:Dermatologic Agents; D008727:Methotrexate