Carcinoid tumors: echocardiographic contribution to the diagnosis.

Pedro Amador, Lígia Mendes, Sara Gonçalves, José Ferreira Santos, Filipe Seixo, Leonor Parreira, Luís Soares


Carcinoid tumors are rare, most commonly originating from the neuroendocrine cells in the gastrointestinal tract. Carcinoid syndrome is characterized by flushing, diarrhea, and bronchospasm. Half of these patients have carcinoid heart disease, affecting the right side of the heart, causing tricuspid and pulmonary regurgitation and stenosis and subsequently right heart failure.73-year-old female was admitted with heart failure associated with episodes of diarrhea and flushing. The echocardiogram showed typical characteristics of carcinoid heart diasease. The CT scan of abdomen showed a small bowel mass. The 24-hour urine 5-hydroxyindoleacetic acid (5HIAA) and indium-111-pentetreotide scintigraphy confirmed the diagnosis. The patient was treated with furosemide, warfarine, digoxin and octreotide and there was clinical improvement.The echocardiogram was very useful, establishing the provisory diagnosis of a rare disease based on pathognomonic echocardiographic features.

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