Korean Circ J.  2013 Sep;43(9):632-635. 10.4070/kcj.2013.43.9.632.

A Case of Dilated Cardiomyopathy with Massive Left Ventricular Thrombus after Use of a Sibutramine-Containing Slimming Product

• Heo SH
• Kang MH

• KMID: 2224820
• DOI: http://doi.org/10.4070/kcj.2013.43.9.632

Abstract

Sibutramine, which acts as an anti-obesity drug by inhibiting reuptake of serotonin and norepinephrine, has now been banned due to cardiovascular adverse effects. However, despite being banned, it is not uncommon for people to purchase products with sibutramine or its analogues used as adulterants in non-prescription slimming products or health foods available on the internet. Sibutramine has been associated with rare but serious adverse reactions such as cardiac arrhythmia including QT interval prolongation, myocardial infarction, and cardiomyopathy, as well as increases in blood pressure and pulse rate. Here, we report a case of a 32-year-old male who presented with dilated cardiomyopathy with massive left ventricular thrombus after taking unauthorized sibutramine-containing slimming pills sold over the internet.

Keyword

Sibutramine; Cardiomyopathy, dilated; Anti-obesity agents

MeSH Terms

Adult
Anti-Obesity Agents
Arrhythmias, Cardiac
Blood Pressure
Cardiomyopathies
Cardiomyopathy, Dilated
Cyclobutanes
Food, Organic
Heart Rate
Humans
Internet
Male
Myocardial Infarction
Norepinephrine
Serotonin
Thrombosis
Anti-Obesity Agents
Cyclobutanes
Norepinephrine
Serotonin

Figure

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  Fig. 1 Chest X-ray shows cardiomegaly and no pulmonary edema.

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  Fig. 2 Initial transthoracic (A, B and C) and transesophageal (D) echocardiograms show severe LV systolic dysfunction and dilatation with multiple, pedunculated thrombi attached to LV apical wall. LV: left ventricle.

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  Fig. 3 Multi-detector computed tomography shows no intraluminal narrowing in coronary artery.

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  Fig. 4 Follow-up transthoracic echocardiogram demonstrates significantly improved LV systolic function and dilatation together with complete resolution of LV thrombus. A: end diastolic period on apical 4-chamber view. B: end systolic period on apical 4-chamber view. C: end diastolic period on PSAX mid-ventricular view. D: end systolic period on PSAX mid-ventricular view. LV: left ventricle, PSAX: parasternal short axis.

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