Drugs and Valvular Heart Disease

In 1997, Connolly et al. reported that both racemic fenfluramine (Pondimin) and dexfenfluramine (Redux) were associated with valvular heart disease.1 The valvular abnormalities seen in patients treated with these agents were distinctive. On echocardiography, leaflet thickening as well as chordal thickening and retraction were observed. Surgically removed valves were noted to have a glistening white surface, with histologic evidence of a plaque-like process extending along the leaflet surfaces and encasing the chordae tendineae. These findings were similar to those in patients with heart-valve damage induced by serotonin-secreting carcinoid tumors.1 This association of racemic fenfluramine and dexfenfluramine with valvular heart disease . . .