Valvular Heart Disease Associated with Dexfenfluramine

Abstract

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.