Valvular heart disease associated with fenfluramine detected 7 years after discontinuation of treatment

Ann Thorac Surg. 2007 Apr;83(4):1541-3. doi: 10.1016/j.athoracsur.2006.11.031.


We report the case of a patient referred to us for mitral and aortic valvular disease with a rheumatic appearance. The unusual macroscopic appearance on valve resection was not compatible with a rheumatic cause. A detailed review of this patient's clinical history (ie, a history of treatment with fenfluramine) suggested an iatrogenic cause, which was confirmed by histology. For the first time, a case of valvular heart disease that deteriorated was discovered 7 years after treatment with fenfluramine, whereas this iatrogenic disease classically resolves after discontinuation of treatment. This case illustrates the need for continuing heart valve surveillance of patients who have used these anorectics.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aortic Valve / pathology
  • Aortic Valve / surgery
  • Biopsy, Needle
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Fenfluramine / administration & dosage
  • Fenfluramine / adverse effects*
  • Follow-Up Studies
  • Heart Valve Diseases / chemically induced*
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Iatrogenic Disease*
  • Immunohistochemistry
  • Mitral Valve / pathology
  • Mitral Valve / surgery
  • Risk Assessment
  • Serotonin Agents / administration & dosage
  • Serotonin Agents / adverse effects*
  • Time Factors
  • Treatment Outcome


  • Serotonin Agents
  • Fenfluramine