Magnetic Resonance Imaging of Carcinoid Heart Disease

Clin Cardiol. 2009 Jun;32(6):E92-3. doi: 10.1002/clc.20260.

Abstract

In a 56-year-old lady, a carcinoid tumor of the terminal ileum metastasized to regional lymph nodes, and the liver was removed by hemicolectomy in 2002. Following a history of cutaneous flushing, diarrhea, and bronchoconstriction 3 years later, a somatostatin therapy was instituted. As flushing and diarrhea resolved and levels of urinary excretion of 5-hydoxyindoleacetic acid decreased, shortness of breath was progressive and prompted a cardiac exam. Despite poor resolution, echocardiography revealed a thickening of the tricuspid valves (TK) with reduced mobility along with right atrial (RA) and right ventricular (RV) dilatation. The pulmonary valve was unobtrusive. Magnetic resonance (MR) imaging revealed extensive fibrous tissue extending from the valvular base to the tip of the tricuspid leaflets. Retraction and immobilization of the TK caused a mild stenosis and a large regurgitant flow. Because medical treatment of tricuspid regurgitation was ineffective, the TK was excised and a Hancock 25-mm bioprosthetic valve was implanted. The postoperative course was uncomplicated, and the patient recuperated and resumed normal daily activities.

Publication types

  • Case Reports

MeSH terms

  • Bioprosthesis
  • Carcinoid Heart Disease / complications
  • Carcinoid Heart Disease / diagnosis*
  • Carcinoid Heart Disease / surgery
  • Cardiovascular Agents / therapeutic use
  • Disease Progression
  • Female
  • Fibrosis
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation / instrumentation
  • Humans
  • Magnetic Resonance Imaging, Cine*
  • Middle Aged
  • Predictive Value of Tests
  • Treatment Outcome
  • Tricuspid Valve / pathology*
  • Tricuspid Valve / surgery
  • Tricuspid Valve Insufficiency / diagnosis*
  • Tricuspid Valve Insufficiency / etiology
  • Tricuspid Valve Insufficiency / surgery

Substances

  • Cardiovascular Agents