Carcinoid heart disease: a potentially fatal complication of carcinoid syndrome

BMJ Case Rep. 2023 Dec 6;16(12):e255518. doi: 10.1136/bcr-2023-255518.

Abstract

Carcinoid heart disease is a unique and serious cardiac complication of the neuroendocrine tumour that affects the right side of the heart, especially the tricuspid and pulmonic valves, eventually causing right heart failure. We present a middle-aged man with a history of well-differentiated neuroendocrine tumours of the small intestine with extensive metastases to the liver, mesentery and spine who is receiving monthly octreotide therapy. He presented with generalised fatigue, severe ascites and worsening dyspnoea. Both the transthoracic echocardiography and transoesophageal echocardiography revealed severe tricuspid and pulmonic regurgitations. He was considered a poor surgical candidate, underwent transcatheter pulmonic valve replacement with two bioprosthetic valve-in-valve implantations and was discharged in a stable condition.

Keywords: Interventional cardiology; Valvar diseases.

Publication types

  • Case Reports

MeSH terms

  • Carcinoid Heart Disease* / complications
  • Carcinoid Heart Disease* / diagnostic imaging
  • Echocardiography
  • Echocardiography, Transesophageal
  • Humans
  • Male
  • Middle Aged
  • Neuroendocrine Tumors* / complications
  • Octreotide / therapeutic use
  • Pulmonary Valve* / diagnostic imaging

Substances

  • Octreotide