Carcinoid Heart Disease: A Review

Area of Science:

• Cardiology
• Oncology
• Cardiac Surgery

Background:

• Carcinoid heart disease (CHD) is a significant cause of death in patients with carcinoid syndrome and metastatic neuroendocrine tumors (NETs).
• Early detection of CHD is challenging due to the low sensitivity of initial symptoms and signs.

Purpose of the Study:

• To emphasize the critical role of early screening for carcinoid heart disease in patients with metastatic neuroendocrine tumors.
• To highlight the importance of cardiac surgery as the definitive treatment for advanced CHD.

Main Methods:

• Screening all patients with metastatic neuroendocrine tumors using N-terminal pro-B-type natriuretic peptide (NT-proBNP) and transthoracic echocardiography.
• Multidisciplinary assessment of cardiac status, hormonal syndrome, and tumor burden to guide surgical timing.

Main Results:

• Early screening methods are vital for detecting carcinoid heart disease due to low sensitivity of clinical presentation.
• Cardiac surgery is the only definitive therapy for advanced CHD, leading to improved symptoms and survival.

Conclusions:

• Prompt screening and timely surgical intervention are essential for managing carcinoid heart disease in patients with metastatic neuroendocrine tumors.
• A multidisciplinary approach is critical for optimizing surgical timing and patient outcomes.