Q. Can Redux cause pulmonary hypertension?

Answered by
Dr. Anshul Varshney
and medically reviewed by Dr. Sneha Kannan
Published on Dec 21, 2015 and last reviewed on: Mar 20, 2019

Hi doctor,

Around 15 years ago, I had Redux for three months. Some 10 years back, I had an echocardiogram. The finding was very mild mitral valve regurgitation and everything else was good. Three years back when my brother had heart bypass, my doctor advised me to undergo some heart tests. I had them and they were fine. Even last year, my echo and stress were fine. I went in today for my yearly follow up and the doctor said that he wants to do a follow up echocardiogram. Because, some value on my last year echo was 58 and it is not supposed to be over 25. He said few reasons, but I did not really understand. Then he said something about checking for pulmonary hypertension. I read about that on the internet; as it is a fatal disease, I am frantic now. When I asked the nurse, she said his notes say that I have no symptoms and no other indications too. I have attached all my echo reports. Could Redux be the reason for pulmonary hypertension? The nurse said that my last year echo was normal except for the 58 value. Please clear my doubt.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome to icliniq.com.

  • Dexfenfluramine - Redux was banned because of causing pulmonary artery hypertension.
  • In earlier days, doctors thought that Redux would cause pulmonary artery hypertension during the course of treatment. But, later we have found a lot of patients who developed pulmonary artery hypertension later in life.
  • The numbers you are talking about seem to be of pulmonary artery pressure and yes, it is high. However, the good news is that you are asymptomatic.
  • As you do not have any symptoms, at this point of life you do not have to worry about the death.
  • A lot many people have pulmonary artery hypertension which is diagnosed by chance in investigations. But, they live a normal life if they are asymptomatic.
  • Even if they have symptoms, we have a number of drugs that can be used to reduce the pulmonary hypertension like Sildenafil, Prostaglandin inhibitors.
  • The most important thing here is the confirmation of the cause that could have resulted in pulmonary hypertension.
  • I would recommend for CT pulmonary angiography to rule out any small emboli causing the problem.
  • Do not panic. We can even treat severe symptomatic pulmonary hypertension. Your condition seems to be an uncomplicated one.

Thank you doctor,

How likely is it to due to Redux? I understand this is a fatal disease with life expectancy less than five years. I am terrified. I am having another echo next Friday. I just do not understand. Everything I have read says it as rare, from 1 in 100,000 to 1 in a million.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome back to icliniq.com.

  • I have seen many cases and there are case reports as well that Redux treatment can cause pulmonary artery hypertension later in life.
  • So, I am assuming that and hence to rule out the possibilities of any other cause of such pulmonary hypertension, I am advising you a CT pulmonary angiography.
  • What you have been reading on internet is just extreme. You are asymptomatic, so it is very unlikely that your life span would be just five years because of this disease.
  • I have my patients living well from last 20 years with severe pulmonary artery disease. Just the quality of life is poor and that too because they are symptomatic.
  • You have however not shared with me your recent echo report. Also, do you remember when you stopped taking Redux?
  • Do you have any habit of smoking or alcohol consumption?
  • Did you take any steroids or contraception pills earlier? What are the other medicine you have been taking?

Revert back with the answers for the above questions to a cardiologist online -->  https://www.icliniq.com/ask-a-doctor-online/cardiologist

Hi doctor,

I am sorry to say that I do not have a copy of the latest echo. I asked the nurse and she said it was normal except for the 58 pulmonary hypertension and mild something else. I do not remember as I was so upset that time. I took Redux for about 3 months and stopped before 20 years. I took birth control pills may be around 30 years back. I did not take any steroid. Now, I am on Lovastatin 40 mg and Metoprolol 25 mg half morning and half evening. Other than that vitamins, garlic, CoQ10, Baby Aspirin, some supplements and an over the counter pill to help control sugar. I never smoked and will have only very little alcohol.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome back to icliniq.com.

  • Your history is clear and is not suggestive of any issues or medicines pertaining to pulmonary hypertension.
  • No issues, if you do not have latest echo report. It is probably pulmonary hypertension.

For further information consult a cardiologist online -->  https://www.icliniq.com/ask-a-doctor-online/cardiologist

Hi doctor,

I have attached the papers which my doctor gave me. Please check.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome back to icliniq.com.

  • Yes, I have seen the report (attachment removed to protect patient identity). There is nothing gross found.
  • Your history is clear and there is no evidence of any activity causing pulmonary artery disease.
  • Moreover, start exercise. Keep your blood pressure under strict control.
  • There is no indication of taking the medicine. Just get CT pulmonary angiography.

Revert back with the scan report to a cardiologist online -->  https://www.icliniq.com/ask-a-doctor-online/cardiologist

Hi doctor,

I received my latest echo and report notes from my doctor. I am terrified of pulmonary hypertension. But, my numbers did go low.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi.

Welcome back to icliniq.com.

  • I am glad to know that your numbers have got down. I would like to see the reports.

Revert back with the scan report to a cardiologist online -->  https://www.icliniq.com/ask-a-doctor-online/cardiologist

Hi doctor,

I am attaching my latest echo as well as my doctor notes. Please give me your opinion. Thank you.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hello,

Welcome back to icliniq.com.

  • I have seen the attached reports (attachment removed to protect patient identity) and would like to congratulate you that the reports are good. In fact, the pulmonary artery hypertension  is found as insignificant.
  • I suppose, he is right your previous echo report was just an echo anomaly.
  • The reason we both are stating this is that usually once if pulmonary hypertension develops, it is very rare to see its regression.
  • So, I would also suggest the same. Repeat your echo after one year.
  • I do not find any reason to worry here. However, if you have any current symptoms please let me know.

For further information consult a cardiologist online -->  https://www.icliniq.com/ask-a-doctor-online/cardiologist

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