The Silent Valve Culprit: A Case Report and Literature Review of Isolated Cabergoline-Induced Mitral Regurgitation

Cabergoline is an ergot-derivative dopamine agonist, widely used in the management of hyperprolactinemia and Parkinson's disease. However, its long-term use is associated with cardiac toxicity linked to its affinity for serotonin receptors present in valve tissue. This serotonin agonist activity can induce valvular heart disease, with a spectrum of severity ranging from mild involvement to severe hemodynamic compromise. We report a case of isolated mitral regurgitation in a 58-year-old male patient with a 12-year history of Parkinson's disease, presenting with inaugural acute decompensated heart failure in the context of previously unrecognized long-term cabergoline exposure. The toxicity manifested after a latency of nine years and significantly impacted quality of life. We additionally conducted a literature review to better elucidate the clinical manifestations, patient outcomes, and other molecules sharing a similar cardiotoxicity profile. This case underscores the need to consider drug-induced valvular heart disease in the differential diagnosis, especially in regions where rheumatic etiology dominates the clinical landscape. Baseline and follow-up echocardiographic evaluations in patients receiving long-term cabergoline therapy are essential for early detection and prevention of irreversible valvular damage.