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Arguing in his book that, since its introduction in 1987, Prozac has been connected to only eight instances of PPH out of 19 million users worldwide, he surmises that the differences in the way Prozac and fenfluramine affect serotonin levels account for the prevalence of cardiac effects in phen-fen users.

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Physicians and surgeons at Mayo noted the first case of valvular heart disease following fen-phen therapy about a year ago.

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