Valve replacement for appetite suppressant-induced valvular heart disease

Valvular heart disease associated with the use of appetite-suppressant medi cation is a recently described clinical entity. Although the mechanism of v alvular injury remains elusive pathologically, the valvular abnormalities r esemble those observed in carcinoid syndrome. The incidence of clinically e vident valvular heart disease is low with short-term (less than 3 months) e xposure to appetite-suppressant drugs. Prolonged exposure to higher doses i n addition to combination drug therapy confers an excess risk for valvular pathologic changes. We report the case of a patient with severe mitral regu rgitation who had short-term exposure (3 weeks) to the combination of fenfl uramine (20 mg) and phenteramine (15 mg). (C) 1999 by The Society of Thorac ic Surgeons.