Fen-phen may pose further risks
Echocardiography may be warranted
The August 1997 issue of Cost Management in Cardiac Care carried an alert regarding potential complications in patients who could be taking a popular weight-loss drug combination fenfluramine and phentermine, popularly dubbed fen-phen. The alert advised to look for valvular heart disease and interactions between fen-phen and serotonin reuptake inhibitors such as Prozac, Zoloft, or Effexor, or drugs for migraine therapy such as Imitrex or dihydroergotamine.
If valvular dysfunction is demonstrated, states a new advisory from the American Heart Association (AHA), the patient may be at increased risk for developing bacterial endocarditis and should receive an antibiotic prior to dental or surgical procedures likely to introduce bacteria into the bloodstream.
Patients may be anxious about stories they read and see in the news regarding this and may be unsure as to whether other appetite suppressants may cause damage to their heart valves. Patients and physicians alike, states the AHA, may wonder who should undergo echocardiography. Recent guidelines published by the American College of Cardiology and AHA Task Force on Echocardiography emphasize that echocardiography is indicated in a patient with a heart murmur and cardiorespiratory symptoms, or in a patient without symptoms who has a murmur if the clinical features indicate a moderate probability of cardiovascular disease.
A physical examination may be sufficient to indicate the presence or absence of significant valvular dysfunction, states the AHA. Echocardiography is likely to be most helpful for patients whose clinical evaluation suggests valvular heart disease or pulmonary hypertension.
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