Valvular Heart Disease Associated with Dexfenfluramine

To the Editor: The appetite-suppressant drugs fenfluramine, dexfenfluramine (the purified d isomer of fenfluramine), and phentermine have each been associated with an increased risk of pulmonary hypertension when used alone.1–3 In this issue of the Journal, an unusual form of valvular heart disease is reported to be associated with use of the combination drug fenfluramine–phentermine,4 but whether valvular disease is also associated with use of the single agent dexfenfluramine is unknown. We wish to report a case of unusual valvular heart disease involving primarily the mitral valve in a young woman taking dexfenfluramine. A 32-year-old woman was referred for . . .