Aortic and mitral valve disease induced by ergotamine therapy for migraine: a case report and review of the literature.
A case of aortic and mitral valve disease associated with ergotamine abuse is reported. A 34-year-old woman presented with dyspnea after a long standing history of peripheral vascular pathology associated with ergotamine abuse. Cardiac dysfunction was rapidly progressive. At surgery, nodular thickening of both valves and fusion of the posterior leaflet of the mitral valve were seen. Microscopy revealed proliferation of myofibroblasts with little destruction of normal valvular elements. The similarity to lesions in carcinoid heart disease and in methysergide-associated valvular disease suggests direct stimulation of myofibroblast growth by serotonin agonist effect.
Hendrikx
M
M
Department of Cardiac Surgery, University Hospital Gasthuisberg, Universitaire Ziekenhuizen Leuven, Belgium.
Van Dorpe
J
J
Flameng
W
W
Daenen
W
W
D000328:Adult; D001021:Aortic Valve / Q000473:pathology; D002110:Caffeine / Q000009:adverse effects* / Q000627:therapeutic use; D004338:Drug Combinations; D004878:Ergotamine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006349:Heart Valve Diseases / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy; D008943:Mitral Valve / Q000473:pathology
D004338:Drug Combinations; C037330:caffeine, ergotamine drug combination; D002110:Caffeine; D004878:Ergotamine