Valve Disease Associated with Ergot Alkaloid Use: Echocardiographic and Pathologic Correlations
Authors: Margaret M. Redfield, Walter J. Nicholson, William D. Edwards, A. Jamil Tajik
Journal: Annals of Internal Medicine (1992)

Brief Reports1 July 1992Valve Disease Associated with Ergot Alkaloid Use: Echocardiographic and Pathologic CorrelationsMargaret M. Redfield, MD, Walter J. Nicholson, MD, William D. Edwards, MD, A. Jamil Tajik, MDMargaret M. Redfield, MD, Walter J. Nicholson, MD, William D. Edwards, MD, A. Jamil Tajik, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-1-50 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptErgot alkaloid preparations such as ergotamine (Cafergot, Sandoz, East Hanover, New Jersey) and methysergide (Sansert, Sandoz) are used to treat migraine headache. Characteristic histologic changes are seen in patients with methysergide-induced valvular disease (primarily mitral and aortic regurgitation) (1, 2). Recently, ergotamine-induced valvular disease was documented pathologically (3). We report the echocardiographic and pathologic features of five patients with valvular disease associated with long-term ingestion of ergot alkaloids.PatientsCase HistoriesAll patients were using ergot alkaloid preparations for treatment of headache. Patients were initially identified because gross pathologic findings were thought to be unusually severe for rheumatic disease. The...References1. BanaMacNealLeCompteShahGraham DPPYJ. Cardiac murmurs and endocardial fibrosis associated with methysergide therapy. Am Heart J. 1974;88:640-55. CrossrefMedlineGoogle Scholar2. Misch K. Development of heart valve lesions during methysergide therapy. Br Med J. 1974;2:365-6. CrossrefMedlineGoogle Scholar3. HauckEdwardsDanielsonMullanyBresnahan AWGCD. Mitral and aortic valve disease associated with ergotamine therapy for migraine: report of two cases and review of literature. Arch Pathol Lab Med. 1990;114:62-4. MedlineGoogle Scholar4. MunroeAllenCox DPA. Mitral regurgitation occurring during methysergide (Sansert) therapy. Can Med Assoc J. 1969;101:62-5. MedlineGoogle Scholar5. MasonBillinghamFriedman JMJ. Methysergide-induced heart disease: a case of multivalvular and myocardial fibrosis. Circulation. 1977;56:889-90. CrossrefMedlineGoogle Scholar6. Spierings E. Cardiac murmurs indicative of aortic valve disease with chronic and excessive intake of ergotamine. Headache. 1988;28:278-9. CrossrefMedlineGoogle Scholar7. SeilerJenzerKàcl KHJ. Verlauf eines Falles von Ergotismus mit Femoralarterienverschlüssen und Mitralinsuffizienz. Vasa. 1973;2:366-71. MedlineGoogle Scholar8. Graham J. Cardiac and pulmonary fibrosis during methysergide therapy for headache. Am J Med Sci. 1967;254:1-12. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From Mayo Clinic and Mayo Foundation, Rochester, Minnesota; and Cardiac Diagnostics Associates, York, Pennsylvania. For current author addresses, see end of text. 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