Carcinoid Heart Disease: a Comprehensive Review

Hassan, Saamir; Palaskas, Nicolas; Agha, Ali; Iliescu, Cezar; Lopez‐Mattei, Juan; Chen, Christopher; Zheng, Henry; Yusuf, Salim

doi:10.1007/s11886-019-1207-8

Cited by 15 publications

(27 citation statements)

References 59 publications

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“…Besides valvular involvement, coronary artery vasospasm is also associated with CaHD and usually presents in patients with a history of nonocclusive coronary artery disease 3 . In the presence of ischemic heart disease, CaHD can lead to coronary artery vasospasm, angina, and in‐stent thrombosis 4 . Arrhythmias, albeit infrequent, might be secondary to increased sympathetic hyperactivity caused by vasoactive chemicals 3 .…”

Section: Discussionmentioning

confidence: 99%

“…All of these medications are merely palliative and cannot prevent the progression of the underlying carcinoid syndrome or cardiac involvement 4 . The pharmacological treatment of CaHD is largely allied to the management of the levels of vasoactive hormones by somatostatin analogs.…”

Section: Discussionmentioning

confidence: 99%

“…What, however, constitutes the appropriate time for the surgical intervention is currently far from clear. There are different scoring systems, principally based on the tricuspid involvement, but the current guidelines generally recommend valve surgery in the presence of severe symptoms or severe valvular disease or progressive asymptomatic RV dysfunction and dilatation 4,9,10 . Some investigators have advised cardiac surgery in groups of patients who have controlled baseline carcinoid tumors, with at least 12 months of anticipated postoperative survival from their neuroendocrine neoplasia 8 .…”

Section: Discussionmentioning

confidence: 99%

“…One of the common complications of carcinoid syndrome is cardiac involvement due to the direct action of vasoactive substances 2 . Carcinoid syndrome can occur in up to 60% of cases during the course of the disease, but carcinoid heart disease (CaHD) can be the first manifestation in approximately 20% of patients 3,4 …”

Section: Introductionmentioning

confidence: 99%

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A forgotten diagnosis in right heart failure: A case report and literature review

Alizadehasl

Galeshi

Peighambari

et al. 2021

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A forgotten diagnosis in right heart failure: A case report and literature review

Alizadehasl

Galeshi

Peighambari

et al. 2021

Clinical Case Reports

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show abstract

“…Carcinoid heart disease is a rare disorder that is associated with significant morbidity and mortality 1 . Cardiac involvement occurs in up to 50% of patients with metastatic carcinoid tumors which commonly affect the right‐sided valves 2 .…”

Section: Figurementioning

confidence: 99%

Three‐dimensional echocardiography assessment of carcinoid valvular heart disease: Images of each and all

Cai

Beckles²,

Ahmad

2020

Echocardiography

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A 54-year-old male with neuroendocrine carcinoma was admitted for syncope. Computed tomography showed a mesenteric mass with internal calcification, consistent with a primary carcinoid tumor ( Figure 1A), and hepatic metastasis ( Figure 1B). Two-dimensional (2D) transthoracic echocardiography (TTE) showed severely dilated right ventricle (RV) and right atrium (RA) (Figure 2A,B). Color and continuous-wave Doppler showed severe tricuspid regurgitation (TR, Figure 2C,D) and pulmonary regurgitation (PR, Figure 2E,F). Threedimensional (3D) TTE en-face views of each of the four valves were displayed (Figure 3A-H, A-D systole and E-H diastole, and Movies S1-S4). The mitral valve (MV) and aortic valve (AV) were normal. The tricuspid valve (TV) and pulmonic valve (PV) leaflets were thickened, retracted, and fixed. All four valves were simultaneously displayed in one plane with en-face view of the TV, MV, and AV (Figure 3I,J), and a longitudinal dissection view of the PV. This unique view demonstrated normal closing and opening of the MV and AV during cardiac cycles. However, the TV and PV remained widely open throughout the cardiac cycle (Movie S5). TV and PV leaflets were found to be completely eroded during open-heart surgery (Figure 4A,B). The patient underwent TV and PV replacements. Abstract A 54-year-old male was found to have neuroendocrine carcinoma with hepatic metastasis. Two-dimensional (2D) transthoracic echocardiography (TTE) demonstrated dilated right ventricle and right atrium, and severe tricuspid and pulmonary regurgitation. Three-dimensional (3D) TTE en-face views showed thickened, retracted, and fixed tricuspid valve and pulmonic valve which remained widely open throughout the cardiac cycle. 3D TTE, particularly en-face views, demonstrates incremental value over 2D TTE by providing precise valvular anatomic details comparable to surgical findings. 3D TTE also offers a unique opportunity to assess all four valves simultaneously with en-face views to delineate their relationships with surrounding structures.

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Multimodality imaging in the diagnostic approach to a patient with carcinoid heart disease involving four heart valves

Khorasani

Parsaee

Samiei

et al. 2022

Clinical Case Reports

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Carcinoid syndrome represents symptoms caused by neuroendocrine tumors-mainly in the gut-resulting in cardiac involvement in about 20% of patients. The disease usually affects the right heart, and the left heart remains spared, as the lungs metabolize the vasoactive substances causing the disease. However, several conditions may lead to both right-and left-sided involvement. These conditions include primary lung neoplasms, any intracardiac shunts, that is, atrial septal defect (ASD), patent foramen ovale (PFO), etc. and the presence of large burden of neoplastic tissue overwhelming the lung inactivation capacity by releasing notable amount of vasoactive substances. 1 Transthoracic echocardiography (TTE) is the first imaging modality used in most cardiac patients. Screening for heart disease in those patients with carcinoid syndrome is of great importance since the patient may have no significant signs or symptoms in the early stages. Based on current evidence, TTE is the recommended modality to screen and monitor carcinoid heart disease. 2

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Carcinoid Heart Disease: a Comprehensive Review

Cited by 15 publications

References 59 publications

A forgotten diagnosis in right heart failure: A case report and literature review

A forgotten diagnosis in right heart failure: A case report and literature review

Three‐dimensional echocardiography assessment of carcinoid valvular heart disease: Images of each and all

Multimodality imaging in the diagnostic approach to a patient with carcinoid heart disease involving four heart valves

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