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Carcinoid constrictive pericarditis.

S D Johnston1, P W Johnston, D O'Rourke

  • 1Department of Medicine, Institute of Clinical Science, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6TJ, UK. sjohnston@potblack.thegap.com

Heart (British Cardiac Society)
|October 20, 1999
PubMed
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A rare case of metastatic carcinoid syndrome caused constrictive pericarditis, leading to heart failure. Despite surgery, the patient succumbed to the condition, highlighting the severe cardiac implications of advanced carcinoid tumors.

Area of Science:

  • Cardiology
  • Oncology
  • Gastroenterology

Background:

  • Carcinoid syndrome, a rare neuroendocrine tumor complication, can manifest with diverse symptoms.
  • Cardiac involvement in carcinoid syndrome, though uncommon, presents significant diagnostic and therapeutic challenges.

Observation:

  • A 78-year-old male presented with diarrhea, anorexia, lower limb edema, atrial fibrillation, pleural effusion, and ascites.
  • Diagnostic workup revealed metastatic carcinoid syndrome and pericardial constriction.
  • Surgical exploration confirmed a thickened pericardium without direct tumor invasion.

Findings:

  • Metastatic carcinoid syndrome was diagnosed based on clinical presentation, imaging, and elevated urinary hydroxyindoleacetic acid.
  • Constrictive pericarditis was identified as the cause of the patient's cardiac symptoms.

Related Experiment Videos

  • The patient's condition rapidly deteriorated post-surgery, leading to mortality.

    • Implications:

    • This case underscores the critical need for early recognition of cardiac complications in metastatic carcinoid syndrome.
    • Constrictive pericarditis secondary to carcinoid syndrome represents a severe, often fatal, manifestation.
    • Further research into the mechanisms and management of carcinoid-associated cardiac disease is warranted.