Carcinoid crisis and reversible right ventricular dysfunction after embolization in untreated carcinoid syndrome.
A 59-year-old white male with carcinoid tumor and hepatic metastases underwent hepatic artery embolization. The patient developed carcinoid crisis and a subsequent transthoracic echocardiogram showed classic findings of carcinoid heart disease along with a dilated hypertrophied right ventricle and severely depressed right ventricular ejection fraction. After treatment with octreotide the patient's clinical condition improved and a repeat transthoracic echocardiogram showed a significant improvement and normalization of right ventricular systolic function. Serotonin levels showed a progressive decline that correlated well with the patient's improved clinical condition. These findings suggest that the acute right ventricular dysfunction was secondary to acute carcinoid crisis and resolution resulted in a significant improvement of both right ventricular systolic function and clinical condition.
Majeed
Farhan
F
University of Nebraska Medical Center, Department of Internal Medicine, 982055 Nebraska Medical Center, Omaha, NE 68198-2055, USA. farhanmajeed1@yahoo.com
Porter
Thomas R
TR
Tarantolo
Stefano
S
Duhachek-Stapelman
Amy
A
Xie
Feng
F
Elhendy
Abdou
A
D000208:Acute Disease; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D002275:Carcinoid Heart Disease / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D002276:Carcinoid Tumor / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D003937:Diagnosis, Differential; D004452:Echocardiography; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*
D018931:Antineoplastic Agents, Hormonal; D015282:Octreotide