Reversible tricuspid regurgitation in a patient undergoing treatment for acute leukemia

A 52-year-old female patient treated for acute lymphoblastic leukemia with combination chemotherapy (cyclophosphamide, vincristine, adriamycin and prednisone), broad spectrum antibiotics and amphotericin via a Hickman catheter placed in the superior vena cava, developed echocardiographically confirmed tricuspid regurgitation. A second admission four months later showed only mild tricuspid regurgitation. The authors conclude that the amphotericin given via the central line caused valvulitis of the tricuspid valve.