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European Journal of Echocardiography Advance Access published online on June 18, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen191
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Valvular heart disease associated with taking low-dose pergolide for restless legs syndrome

Angela Worthington1,* and Liza Thomas2,3

1 Cardiology Department, Westmead Hospital, Cnr Darcy and Hawkesbury Roads, Westmead, NSW 2145, Australia
2 Cardiology Department, Liverpool Hospital, Liverpool, NSW, Australia
3 University of NSW, Randwick, NSW, Australia

Received 3 February 2008; accepted after revision 30 May 2008.

* Corresponding author. Tel: +61 298 455 555. E-mail address: angeworthington{at}gmail.com


  Abstract

A 49-year-old female took low-dose pergolide (625 µg daily) for approx. 5 years (approximately cumulative dose 1.140 g/5 years) for the treatment of restless legs syndrome. She developed moderate to severe mitral and aortic valve insufficiency, requiring semi-urgent double-valve replacement. The initial diagnosis of rheumatic valve disease was refuted on histological examination of the valves due to the lack of typical calcification and neovascularization. Valvular heart disease is associated with the use of dopamine agonists for the treatment of Parkinson's disease and obesity, typically at much higher doses.

Keywords: Pergolide; Restless legs syndrome; Valvular heart disease; Dopamine agonists


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