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Shankha S. Biswas
Joseph M. Forbess
Kevin P. Landolfo
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Ann Thorac Surg 1999;67:1819-1822
© 1999 The Society of Thoracic Surgeons

Current Review

Valve replacement for appetite suppressant–induced valvular heart disease

Shankha S. Biswas, MDa, Carolyn L. Donovan, MDb, Joseph M. Forbess, MDa, Stephen H. Royal, MDb, Kevin P. Landolfo, MDa

a Division of Thoracic and Cardiovascular Surgery, Duke University Medical Center, Durham, North Carolina, USA
b Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA

Address reprint requests to Dr Landolfo, Division of Thoracic and Cardiovascular Surgery, Duke University Medical Center, Box 3857, Durham, NC 27710
e-mail: land001{at}mc.duke.edu

Valvular heart disease associated with the use of appetite-suppressant medication is a recently described clinical entity. Although the mechanism of valvular injury remains elusive pathologically, the valvular abnormalities resemble those observed in carcinoid syndrome. The incidence of clinically evident valvular heart disease is low with short-term (less than 3 months) exposure to appetite-suppressant drugs. Prolonged exposure to higher doses in addition to combination drug therapy confers an excess risk for valvular pathologic changes. We report the case of a patient with severe mitral regurgitation who had short-term exposure (3 weeks) to the combination of fenfluramine (20 mg) and phenteramine (15 mg).




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