Acute hepatitis is an uncommon sequela of herbal supplement use. Regardless, considering the hepatotoxic effects of natural supplements is important, especially in patients taking other medications or substances. We herein describe a case of acute steatohepatitis in a patient who chronically consumed high doses of ashwagandha and other herbal supplements in the context of alcohol use and a multi-medication regimen.

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We report a case of an 18-year-old female who presented with severe aortic stenosis and insufficiency, eight years following resection of a subaortic membrane. On echocardiography, she was found to have a completely fused or nullicuspid valve, with three equal sinuses and three commissural fusions. Aortic valve repair included leaflet tricuspidization, three commissurotomies, trileaflet ring annuloplasty, and pericardial leaflet reconstruction. At one year follow-up, the patient is asymptomatic, with stable gradients.

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