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A causal relationship between treatment with tricyclic antidepressant (TCA) at therapeutic doses and cases of dilated cardiomyopathy has been suspected, but not definitely evidenced. We present a case of a dilated cardiomyopathy, which seemed idiopathic, but occurred during treatment with imipramine and recovered after its withdrawal. For the first recorded time, the cardiomyopathy recurred 9 years later, after a 2-year period of treatment with amitriptyline and lithium, and recovered again 1 year after both psychotropic drugs withdrawal. New arguments for the existence of TCA-induced dilated cardiomyopathy are brought.

Papillary fibroelastoma is a rare, benign endocardial tumour usually located on the cardiac valves. Before echocardiography, these tumours were chance findings either at surgery or at autopsy. With the advent of echocardiography, the diagnosis has become commoner and they are often the cause of systemic embolism justifying surgical ablation. In this case, an aortic valve papillary fibroelastoma presented with myocardial infarction in a 78 year old woman with normal coronary angiography. The diagnosis was strongly suspected at echocardiography and confirmed by histological analysis of the surgically excised tumour.