[Progressive dyspnoea in two patients with carcinoid syndrome].
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.
Nölting
S
S
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.
Nicolaus
M
M
Behr
J
J
Baumgartner
R
R
Mete
H
H
Boekstegers
P
P
Herrmann
K
K
Theisen
D
D
Lehrke
M
M
Göke
B
B
Schirra
J
J
Auernhammer
C J
CJ
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