Carcinoid Heart Disease

 

Image Library Home >> Cardiac Tumors >> Carcinoid Heart Disease

 

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The classic findings of carcinoid heart disease are that of right sided valvular lesions. Deposition of tumor secreted substances causes restriction of the leaflets of tricuspid valve as show here. Note how most of the anterior leaflet (except the very tip) and the posterior leaflet shown here are restricted and do not move in systole and diastole. This individual also has a dilated right atrium and prominent eustachian valve.

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This can cause turbulent flow and a functional tricuspid stenosis in some cases as well as severe tricuspid regurgitation since the tricuspid leaflets do not coapt during systole. Color Doppler demonstrates this nicely as shown on the left.

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The pulmonic valve also has restricted leaflet motion as shown here. The pulmonic valve cusps do not appear to be moving well at all here.

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Color Doppler shows both pulmonic stenosis and regurgitation. This is also shown by CW spectral Doppler below.
 

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Cardiac involvement usually occurs when carcinoid tumors affect the liver. Normally as secreted products from the tumor are metabolized and inactivated by the liver before they reach the heart. When the liver is diseased this doesn't occur. This individual has significant liver involvement as shown by subcostal view on the left.

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Left sided carcinoid heart disease is uncommon because the lungs act as another filter and metabolizer of actively secreted compounds from the tumor. This is another subcostal view showing the extent of liver involvement.