A 57-year-old man with a history of Lewy body dementia was referred for cardiac assessment with a history of exertional dyspnoea and orthopnoea. Symptoms developed 12 months after commencement of cabergoline by his neurologist. Transoesophageal echo demonstrated aortic regurgitation, which was moderate by vena contracta (0.6 cm) (Figure 1). The aortic valve was tricuspid and was not thickened or calcified. The leaflets appeared tethered and failed to coapt (Figure 2). Other cardiac valves were normal. The appearance was typical of that associated with ergot-derived dopamine agonists, so the aortic regurgitation was considered to be secondary to treatment with cabergoline.