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[Left valvular involvement in carcinoid: description of a case]
C Materazzo1, R Meazza, M Stefanelli
1Divisione di Cardiologia, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano.
Giornale Italiano Di Cardiologia
|April 1, 1994
Summary
Metastatic carcinoid tumors commonly cause right-sided heart valve disease. This case report details a rare instance of both right and left heart valve involvement in a patient with carcinoid syndrome.
Area of Science:
- Cardiology
- Oncology
- Medical Imaging
Background:
- Metastatic carcinoid tumors frequently lead to right-sided valvular heart disease.
- Left-sided valvular involvement is an uncommon manifestation of carcinoid syndrome.
Observation:
- A 46-year-old woman presented with symptoms of carcinoid syndrome, including flushing, diarrhea, and abdominal pain.
- Initial echocardiography revealed severe tricuspid regurgitation and pulmonary valve abnormalities, consistent with carcinoid heart disease.
- Subsequent examinations showed mitral and aortic valve involvement without structural abnormalities, despite no right-to-left shunt.
Findings:
- The patient had a confirmed ileal carcinoid tumor with liver metastases and elevated urinary 5-hydroxyindoleacetic acid (5-HIAA).
- Echocardiography and angiography documented severe tricuspid regurgitation and mild pulmonary stenosis.
- Progressive disease led to secondary mitral regurgitation and aortic insufficiency, indicating left-sided valve compromise.
Implications:
- This case highlights the potential for carcinoid syndrome to affect both right and left heart valves sequentially.
- Comprehensive echocardiographic evaluation is crucial for detecting and monitoring valvular heart disease in carcinoid patients.
- Understanding the spectrum of cardiac involvement aids in timely diagnosis and management of carcinoid heart disease.