Cusp tear in bicuspid aortic valve possibly caused by phentermine

A 28 year old woman underwent echocardiography following an incidental finding of a diastolic murmur. She has been taking phentermine for weight reduction for 8 months. Trans-esophageal echocardiography revealed a tear of the posterior cusp of the aortic valve causing severe regurgitation. Phentermine is known to cause valvular disease with prolonged use, but aortic valve rupture was not previously reported as a complication of phentermine valvulopathy.