Is Aortic Regurgitation Associated With Long-Term Ergotamine Use?

There are various causes of acquired valvular heart disease (VHD), one of which is drug induced.

A 62-year-old woman with long-term excessive use of ergotamine for migraines presented with a 1-month history of dyspnea and was admitted for chronic heart failure due to severe aortic regurgitation. Various medications were initiated in combination with dobutamine, resulting in symptomatic improvement. Under compensated heart failure, elective surgical aortic valve replacement was performed. Pathological examination of the excised valve revealed abnormal leaflet fibrosis, which is not usually observed in naturally degenerated aortic leaflets, suggesting ergotamine-induced valvular changes.

This case involved severe aortic regurgitation due to aortic valve fibrosis, possibly caused by long-term ergotamine use, highlighting the need to consider drug-induced etiologies in the differential diagnosis of VHD.

The habitual use of ergotamine can cause valvular fibrosis as an adverse effect, potentially leading to VHD.