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Multimodality Diagnosis and Management of Carcinoid Heart Disease: Outcomes and Long-Term Follow-Up
Nicholas Johnson1, Samuel Krasner1, Andrew Lewis1
1Oxford Heart Centre Department of Cardiology, Oxford University Hospitals, Oxford, United Kingdom; Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.
Insights
Carcinoid heart disease (CHD) is a rare complication of carcinoid tumors affecting heart valves. Early diagnosis and multidisciplinary management are crucial for preventing progression and improving outcomes in patients with carcinoid syndrome.
Area of Science:
- Cardiology
- Oncology
- Valvular Heart Disease
Background:
- Carcinoid heart disease (CHD) is a rare complication of carcinoid tumors, a type of neuroendocrine tumor.
- It predominantly affects the right-sided cardiac valves, leading to significant valvular dysfunction.
- Multidisciplinary management is essential for optimal patient outcomes.
Background:
Carcinoid heart disease (CHD) is the rare but serious complication of a paraneoplastic syndrome caused by carcinoid tumors predominantly affecting right-sided cardiac valves and valvular apparatus, leading to significant valvular dysfunction. Multidisciplinary management is paramount for optimal patient outcomes.
Case Summary:
A 50-year-old man with chronic flushing, diarrhea, and weight loss was diagnosed with CHD. Echocardiography demonstrated resultant severe tricuspid and pulmonary valve degeneration. He underwent dual-valve replacement, followed by liver debulking surgery with good initial results. Subsequently early, significant valve degeneration occurred.
Discussion:
CHD occurs in up to 50% of patients with cardiac syndrome, and insidious symptom onset means diagnosis often delayed. Early investigation and prompt management are therefore imperative to prevent progression and plan multistaged interventions.
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