The use of ergoline dopamine agonists for treatment of Parkinson's disease has recently been associated with the development of valvular heart disease. We here report the case of a patient who revealed severe mitral valve regurgitation and refractory cardiogenic shock during treatment with cabergolin in the absence of other causes for valvular disease. To the best of our knowledge, such a rapid progression and ultimately fatal outcome has not been described yet. Our case reemphasizes that patients with long-term administration of ergolines should be closely monitored for valvular degeneration.