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Methysergide Therapy and Constrictive Pericarditis

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School of Medicine, University of North Carolina at Chapel Hill; Chapel Hill, North Carolina

Ann Intern Med. 1978;88(2):213-214. doi:10.7326/0003-4819-88-2-213
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Methysergide is an ergot alkaloid useful in the treatment of migraine headache. In 1964, Graham (1) described two patients on chronic methysergide therapy who developed retroperitoneal fibrosis. Since then, fibrosis associated with methysergide has also been reported to involve the pleura, lung, endocardium, heart valves, and great vessels (1-3). We describe a patient who developed constrictive pericarditis while on chronic methysergide therapy.

A 77-year-old woman was admitted to North Carolina Memorial Hospital with dyspnea and edema. Five years earlier she was evaluated at an affiliated hospital for a right pleural effusion and pleural fibrosis. At that time, skin testing with


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