Two cases of rosiglitazone related heart failure

We present the cases of two patients, on treatment with rosiglitazone, an oral anti-diabetic agent, who presented with acute shortness of breath due to pulmonary oedema. Both patients had underlying cardiac disease and both patients' condition improved with cessation of rosiglitazone and standard heart failure therapy. There is an association between rosiglitazone and fluid retention and therefore the precipitation of life threatening heart failure with underlying cardiac disease. These cases highlight the need to be aware of the high prevalence of underlying cardiac disease in an older population and the need to exercise caution in prescribing rosiglitazone in this age group.