Caseous necrosis of the mitral annulus: a new feature of drug-induced valvular heart disease? Case series. Issue 1 (16th December 2021)

• Record Type: Journal Article
• Authors: Leblon, Tiphaine; Riolet, Clemence; Ennezat, PierreVladimir; Marechaux, Sylvestre
• Editors: Velagapudi, Poonam; Idris, Amr; Sousa, Carla; Farre, Nuria; Tardo, Daniel; Ahmed, Nida
• Is Part Of: European heart journal. Volume 6:Issue 1(2022)
• Publication Date: 2021-12-16
• Subjects: Caseous necrosis -- Benfluorex -- Mitral annulus -- Case report; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytab516
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: Drug-induced valvular heart disease (DI-VHD) is a well-defined condition associated with specific pathology features. However, clinical presentations may broadly vary and thereby make DI-VHD diagnosis more challenging. Case summary: We report two patients with a history of benfluorex administration, who developed extensive mitral calcific lesions which evolved towards caseous necrosis. Discussion: Prospective follow-up over several years of these two patients who initially had typical DI-VHD findings provided monitoring evidence of extensive calcifications and subsequent caseous necrosis. These reports suggest a link between calcific heart injury and benfluorex exposure. The diagnosis of DI-VHD may be overlooked at this late stage.