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Twenty-four women,mean age 44.8 years,were evaluated for 12.3 months after the initiation of fenfluramine-phentermine therapy.Echocardiography demonstrated unusual valvular morphology and regurgitation in all patients.Both right-sided and left-sided heart valves were involved.Eight women also had newly documented pulmonary hypertension.To date,cardiac surgical intervention has been required in five patients.The heart valves had a glistening white appearance.Histopathologic findings included plaque-like encasement of the leaflets and chordal structures with intact heart valve architecture.The histopathologic features were identical to those seen in carcinoid or ergotamine-induced valve disease.These cases arouse concern that fenfluramine-phentermine therapy may be associated with valvular heart disease.Candidates for fenfluramine-phentermine therapy should be informed about serious potential adverse effects, including pulmonary hypertension and valvular heart disease. |
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