Carcinoid Heart Disease

Area of Science:

• Cardiology
• Oncology
• Biochemistry

Background:

• Carcinoid heart disease (CHD) is a rare, severe complication of advanced neuroendocrine neoplasms associated with carcinoid syndrome.
• Tumor secretion of vasoactive substances, primarily serotonin, leads to characteristic right-sided heart valve disease and subsequent right heart failure.

Purpose of the Study:

• To highlight the importance of screening for carcinoid heart disease (CHD) in patients with neuroendocrine neoplasms and carcinoid syndrome.
• To emphasize the need for appropriate and timely diagnostic measures for CHD.
• To advocate for multidisciplinary care in managing patients with CHD.

Main Methods:

• Monitoring of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels.
• Assessing 5-hydroxyindoleacetic acid (5-HIAA) in urine.
• Utilizing cardiac echocardiography for cardiac assessment.

Main Results:

• Current screening practices for CHD are often inadequate, leading to delayed diagnosis.
• Biomarkers (NT-proBNP, 5-HIAA) and echocardiography are key tools for CHD screening.
• CHD diagnosis and management require a coordinated approach.

Conclusions:

• Appropriate and timely screening for carcinoid heart disease is essential for patients with neuroendocrine tumors and carcinoid syndrome.
• Multidisciplinary care involving medical oncology, cardiology, and cardiothoracic surgery is optimal for managing CHD.
• Early detection and intervention can improve outcomes for patients with this rare but serious condition.