Dynamic drug-induced organic mitral regurgitation during exercise echocardiography following chronic exposure to ergotamine

A 67-year-old woman with a history of hypertension and migraine had been hospitalized 9 months ago for unexplained acute pulmonary oedema with evidence of preserved LV ejection fraction and mild to moderate mitral regurgitation (MR). Coronary angiography was normal, she was in sinus rhythm and blood pressure was normal. She had been exposed continuously to ergotamine (gynergene) for migraine prophylaxis for 30 years (1 to 3 mg of ergotamine). Despite treatment by enalapril and furosemide introduced for heart failure, the patient remained in NYHA functional class III with evidence of preserved LV ejection fraction, mild MR and normal LV filling pressure.

Source: International Journal of Cardiology - March 22, 2015 Category: Cardiology Authors: Sylvestre Maréchaux, Yassine Ben Brahim, Pierre Vladimir Ennezat, François Delelis, Christophe Tribouilloy Tags: Letter to the Editor Source Type: research