Fen-Phen Valve Disease: A Real Entity?

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Abstract
The issue of anorexigen-associated valvular dysfunction and the formation of distinctive lesions predominantly on left-sided heart valves remains an area of intense scientific study and debate. Much controversy remains regarding the specific pathologic and histopathologic features of the myxomatous lesions associated with exposure to anorexigenic agents such as fenfluramine, dexfenfluramine and phentermine. The pathology of heart valve lesions associated with anorexigen exposure must be differentiated from lesions associated with ergotamine and methysergide use and from chronic rheumatic valve disease, floppy valve disease, infective endocarditis and carcinoid heart disease. Heightened awareness of heart valve disease associated with anorexigen exposure as a real pathobiological entity, together with increasing knowledge of the mechanisms involved, should lead to more effective diagnosis and treatment of affected individuals.

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