Long-term low-dose cabergoline usage: Another association with cardiac valvulopathy

Area of Science:

• Endocrinology
• Cardiology
• Pharmacology

Background:

• Hyperprolactinemia, often caused by prolactinomas, is typically managed medically.
• Cabergoline is a dopamine agonist commonly used for hyperprolactinemia treatment.
• Surgical risks may lead patients to opt for long-term medical management.

Observation:

• A 60-year-old patient with hyperprolactinemia and a prolactinoma chose medical management over surgery.
• Initial treatment with bromocriptine was switched to cabergoline due to decreasing efficacy.
• The patient received 18 years of cabergoline therapy at a low weekly dosage (0.5-1 mg).

Findings:

• Echocardiographic monitoring revealed progressive thickening and regurgitation of the aortic and mitral valves.
• These valvular changes were associated with the cumulative dose and duration of cabergoline treatment.
• The case demonstrates valvulopathy occurring with long-term, low-dose cabergoline therapy.

Implications:

• Prolonged cabergoline use, even at low doses, may pose a risk for developing valvular heart disease.
• Regular echocardiographic monitoring is crucial for patients on long-term cabergoline therapy.
• This case underscores the importance of balancing the benefits of prolactinoma treatment with potential cardiovascular side effects.