Carcinoid heart disease: typical findings on echocardiography and cardiac magnetic resonance.
Carcinoid syndrome is often complicated by carcinoid heart disease. Deposition of carcinoid plaques on the endocardium of the tricuspid and pulmonary valves causes the typical echocardiographic iconography with thickening of the leaflets and valvular insufficiency and/or stenosis leading to right heart failure. Additionally, the fibrous plaques can be visualized with cardiac magnetic resonance using delayed enhancement sequences. Accurate assessment of the dimensions of the dilated right ventricle by magnetic resonance implicates therapeutic options and defines prognosis. We report the case of a patient with advanced right heart failure as the clue to the diagnosis of carcinoid syndrome. Echocardiography was suggestive. Advanced investigation with magnetic resonance confirmed carcinoid plaque deposition on the tricuspid and the pulmonary valves, and we also had evidence of plaque deposition in the right ventricle. Multimodality imaging is essential in the investigation of this rare disorder.
Department of Cardiology, AZ Sint-Lucas, Gent, Belgium. Veronique.Moerman@UGent.be
Veronique M
VM
Moerman
Dirk
D
Dewilde
Kurt
K
Hermans
D002275:Carcinoid Heart Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D015150:Echocardiography, Doppler; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011664:Pulmonary Valve / Q000473:pathology*; D012680:Sensitivity and Specificity; D014261:Tricuspid Valve / Q000473:pathology*