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Drug-induced valvular heart disease
  1. Bernard Cosyns1,
  2. Steven Droogmans1,
  3. Raphael Rosenhek2,
  4. Patrizio Lancellotti3
  1. 1Department of Cardiology, UZ Brussel, Brussels, Belgium
  2. 2Department of Cardiology, Medical University Vienna, Vienna, Austria
  3. 3Heart Valve Clinic, Echocardio Department, Intensive Care Unit, University of Liège, CHU Sart Tilman, Liège, Belgium
  1. Correspondence to Professor Bernard Cosyns, CHIREC, Department of Cardiology, 35 rue Wayez, 1420 Braine l'Alleud, Belgium; bcosyns{at}


Drug-induced valvular heart disease (DIVHD) was first described in the 1960s. Initially, associations with ergot derivatives used for migraine prevention, or with anorectic drugs, were described. Drugs used for the treatment of Parkinson’s disease and endocrine diseases, like hyperprolactinemia, may also induce VHD. More recently, the use of 3,4-methylendioxymetamphetamine (MDMA, ‘Ecstasy’) and benfluorexhave been found to be associated with DIVHD. Although some of these drugs were withdrawn from the market, several cases of patients requiring valve surgery even years after the cessation of therapy have been reported. DIVHD is not infrequent, may be severe, and has been described in association with several drugs. Even after drug cessation, long-term implications of this type of VHD may persist. The present review underlines the need for a careful evaluation of the associated clinical and echocardiographic risk factors to allow early recognition so as not to delay appropriate management.

  • Drug-induced valvular disease
  • benfluorex
  • serotoninergic drugs
  • carcinoid syndrome
  • valvular disease
  • imaging and diagnostics
  • echocardiography
  • three dimensional
  • malignency
  • chemotherapy
  • transthoracic
  • infection
  • endocarditis
  • metabolic medicine
  • diabetic heart disease
  • cardiomyopathy
  • aortic valve disease
  • aortic stenosis
  • valvular heart disease
  • valve disease
  • myocardial disease
  • cardiomyopathy restrictive
  • diastolic function
  • congestive heart failure
  • heart failure

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.