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Carcinoid Heart Disease: Starting From Heart Failure
Nicole Bertin1, Serena Favretto2, Francesco Pelizzo3
1University of Udine, Udine, Italy.
Summary
Carcinoid syndrome, a condition caused by neuroendocrine tumors, can lead to carcinoid heart disease. This case highlights typical echocardiographic findings in a patient with metastatic disease.
Area of Science:
- Oncology
- Cardiology
- Radiology
Background:
- Carcinoid syndrome results from vasoactive substances released by carcinoid tumors.
- Carcinoid heart disease affects over 50% of patients with carcinoid syndrome, sometimes as the first sign.
- Neuroendocrine tumors can metastasize and present with cardiac complications.
Purpose of the Study:
- To report a case of metastatic neuroendocrine tumor presenting with carcinoid heart disease.
- To review the typical echocardiographic findings associated with carcinoid heart disease.
- To discuss the clinical management challenges in advanced metastatic disease.
Main Methods:
- Case report of a 75-year-old woman with metastatic neuroendocrine tumor.
- Transthoracic echocardiography to assess cardiac function and valvular integrity.
- Abdominal computed tomography (CT) to identify tumor location and metastatic spread.
- Systematic literature review on echocardiographic findings in carcinoid heart disease.
Main Results:
- The patient presented with fatigue and heart failure, indicative of advanced disease.
- Echocardiography revealed severe tricuspid and pulmonic regurgitation, characteristic of carcinoid heart disease.
- Abdominal CT identified a hypervascular retroperitoneal mass originating from the mesenteric artery.
- The patient was ineligible for surgical intervention due to metastatic burden and poor condition.
Conclusions:
- Carcinoid heart disease is a significant complication of neuroendocrine tumors and carcinoid syndrome.
- Echocardiography is crucial for diagnosing carcinoid heart disease, showing characteristic valvular lesions.
- Management of carcinoid heart disease in advanced metastatic settings is challenging.
- Systematic review reinforces the importance of echocardiographic assessment in these patients.
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