Cardiovascular Disease Associated with the Chronic Use of Ergotamine: A Case Report


Cardiovascular Disease Associated with the Chronic Use of Ergotamine: A Case Report

Vesga C 1* Sotomayor JA2 , Giraldo-González GC3

1Department of Cardiology, Fundación Valle del Lili, Cra 98 #18-49, Cali, Colombia. Universidad Icesi, Health Sciences Faculty, Calle 18 No. 122-135, Cali, Colombia.
2Internal Medicine Resident, Universidad Icesi, Health Sciences Faculty, Calle 18 No. 122-135, Cali, Colombia.
3Cardiology fellow, Universidad Icesi, Health Sciences Faculty, Calle 18 No. 122-135, Cali, Colombia.


International-Journal-of-Case-Reports-2d code

Ergotamine and its derivatives were used for multiple diseases; in the nineties, its use in association with caffeine was considered a standard treatment for migraines, although it has been in decline, due to the evidenced toxic effects related to its chronic use including vascular, cardiovascular and central nervous system manifestations. In this article is reported a case of a 59-year-old female with chronic use of caffeine plus ergotamine for more than 20 years; afterwards she develops peripheral artery disease, severe mitral and tricuspid valve regurgitation with requirement of valve replacement. In the absence of past cardiovascular history and rheumatic fever, its clinical evolution and pathology results are associated with ergotism.


Conflicts of interests: The authors have no conflicts of interests to declare.


Acknowledgement: to the Clinical Research Center of Fundación Valle del Lili for their support.


Keywords: Ergotamine, caffeine, ergotamine drug combination, valvular disease, cardiovascular disease.


Free Full-text PDF


How to cite this article:
Vesga C, Sotomayor JA, Giraldo-González GC. Cardiovascular Disease Associated with the Chronic Use of Ergotamine: a Case Report. International Journal of Case Reports, 2018 3:45. DOI:10.28933/ijcr-2018-10-2208


References:

1. Minen MT, Younger DS. Epidemiology of Migraine. Neurol Clin. 2016;34(4):849-861. doi:10.1016/j.ncl.2016.06.011
2. Roberto G, Raschi E, Piccinni C, et al. Adverse cardiovascular events associated with triptans and ergotamines for treatment of migraine: Systematic review of observational studies. Cephalalgia. 2015;35(2):118-131. doi:10.1177/0333102414550416
3. Katz AI, Massry SG. Arteriospasm After Ergotamine Tartrate in Infectious Hepatitis. Arch Intern Med. 1966;118(1):62-64. doi:10.1001/archinte.1966.00290130064011
4. Zanettini R, Antonini A, Gatto G, Gentile R, Tesei S, Pezzoli G. Regression of cardiac valvulopathy related to ergot-derived dopamine agonists. Cardiovasc Ther. 2011;29(6):404-410. doi:10.1111/j.1755-5922.2010.00169.x
5. Lazopoulos G, Papaioannou G, Kantartzis M. Cardiac surgery for ergotamine-induced multivalvular heart disease. Thorac Cardiovasc Surg. 2013;61(5):435-437. doi:10.1055/s-0032-1331580
6. Donnet A, Braunstein D, Pradel V, et al. Ergot Use and Overuse: A Pharmacoepidemiology Retrospective Cohort Study. Headache. 2016;56(3):547-554. doi:10.1111/head.12776
7. Roithinger FX, Punzengruber C, Gremmel F, Hinterreiter M, Holzner F, Pachinger O. Myocardial infarction after chronic ergotamine abuse. Eur Heart J. 1993;14(11):1579-1581. http://www.ncbi.nlm.nih.gov/pubmed/8299645. Accessed April 5, 2018.
8. Schiff PL. TEACHERS’ TOPICS Ergot and Its Alkaloids HISTORY OF ERGOT. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1637017/pdf/ajpe98.pdf. Accessed April 5, 2018.
9. Rasmussen VG, Poulsen SH, Dupont E, Østergaard K, Safikhany G, Egeblad H. Heart valve disease associated with treatment with ergot-derived dopamine agonists: A clinical and echocardiographic study of patients with Parkinson’s disease. J Intern Med. 2008;263(1):90-98. doi:10.1111/j.1365-2796.2007.01874.x
10. Martínez Quintana E, Llorens León R, Redondo Martínez E, Nieto Lago V, Jiménez Cabrera F, Gross Kastanovitz E. Valvular Heart Disease Associated With Ergotamine. Rev Española Cardiol (English Ed. 2005;58(1):97-99. doi:10.1016/S1885-5857(06)60238-7
11. Claudia A. Liegl, BSc Michael A. McGrath, MD F. Ergotism: Case Report and Review of the Literature. Int J Angio. 2016:e8-e11. doi:10.1542/peds.113.4.e380
12. Austin SM, El-Hayek A, Comianos M, Tamulonis DJ. Mitral valve disease associated with long-term ergotamine use. South Med J. 1993;86(10):1179-1181. http://www.ncbi.nlm.nih.gov/pubmed/8211344. Accessed April 5, 2018.
13. Rothman RB, Baumann MH, Savage JE, et al. Evidence for possible involvement of 5-HT(2B) receptors in the cardiac valvulopathy associated with fenfluramine and other serotonergic medications. Circulation. 2000;102(23):2836-2841. http://www.ncbi.nlm.nih.gov/pubmed/11104741. Accessed April 5, 2018.
14. Rasmussen VG, Poulsen SH, Dupont E, Ostergaard K, Safikhany G, Egeblad H. Ergotamine-derived dopamine agonists and left ventricular function in Parkinson patients: systolic and diastolic function studied by conventional echocardiography, tissue Doppler imaging, and two-dimensional speckle tracking. Eur J Echocardiogr. 2008;9(6):803-808. doi:10.1093/ejechocard/jen160
15. Loder E, Burch R, Rizzoli P. The 2012 AHS / AAN Guidelines for Prevention of Episodic Migraine : A Summary and Comparison With Other Recent. 2012:930-945. doi:10.1111/j.1526-4610.2012.02185.