title: [Progressive dyspnoea in two patients with carcinoid syndrome].
abstract: In patients with carcinoid syndrome, there has always to be considered cardiac impairment. We report about two patients with hepatic and bone metastases of a neuroendocrine tumor of the midgut, who suffered from progressive dyspnea. This was caused in both cases by a right-to-left atrial shunt, in case 1 based on a patent foramen ovale (PFO), in case 2 based on a secundum atrial septal defect. Symptoms were significantly reduced by percutaneous closure of PFO and ASD, respectively. Right-to-left atrial shunt was facilitated by right-sided carcinoid induced endocardial fibrosis with the consequence of severe tricuspid regurgitation, leading to an increase of right atrial pressure.
authors.affiliation: Medizinische Klinik II, Campus Großhadern, Klinikum der Ludwig-Maximilians-Universität München, Interdisziplinäres Zentrum für Neuroendokrine Tumoren des GastroEnteroPankratischen Systems (GEPNET-KUM), Marchioninistraße 15, 81377, München.
authors.forename: S
authors.initials: S
authors.lastname: Nölting
authors.forename: M
authors.initials: M
authors.lastname: Nicolaus
authors.forename: J
authors.initials: J
authors.lastname: Behr
authors.forename: R
authors.initials: R
authors.lastname: Baumgartner
authors.forename: H
authors.initials: H
authors.lastname: Mete
authors.forename: P
authors.initials: P
authors.lastname: Boekstegers
authors.forename: K
authors.initials: K
authors.lastname: Herrmann
authors.forename: D
authors.initials: D
authors.lastname: Theisen
authors.forename: M
authors.initials: M
authors.lastname: Lehrke
authors.forename: B
authors.initials: B
authors.lastname: Göke
authors.forename: J
authors.initials: J
authors.lastname: Schirra
authors.forename: C J
authors.initials: CJ
authors.lastname: Auernhammer
mesh_terms: D000368:Aged; D002275:Carcinoid Heart Disease / Q000175:diagnosis* / Q000628:therapy; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000628:therapy; D003131:Combined Modality Therapy; D004417:Dyspnea / Q000209:etiology*; D017548:Echocardiography, Transesophageal; D005260:Female; D054092:Foramen Ovale, Patent / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008303:Malignant Carcinoid Syndrome / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D055989:Septal Occluder Device; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000628:therapy