In brief, the incidence of restrictive valvular heart disease in PD patients on pergolide again appears to be substantially lower than previously reported. Together with the fact of relatively high general occurrence of nonspecific heart valvular changes in the elderly, it underlines the importance of thoughtful cardiologic consultation in PD patients and appeals to a reevaluation of the risks of pergolide treatment, balancing them with drawbacks of drug switching and potential side effects of DA substitutes