carcinoid heart disease
Cardiac valvular fibrosis and dysfunction caused by serotonin excess in carcinoid syndrome.
Full Definition
Carcinoid heart disease is a serious complication of carcinoid syndrome, occurring in approximately 50-60% of patients with metastatic carcinoid tumors and elevated 5-HIAA levels. The condition is characterized by fibrous plaque deposits on the endocardium, particularly affecting the tricuspid and pulmonary valves on the right side of the heart. These deposits lead to valve thickening, retraction, and fixation, resulting in regurgitation and/or stenosis. The pathophysiology involves direct cardiac exposure to serotonin and other vasoactive substances released by liver metastases into the hepatic veins. Left-sided heart involvement is rare unless there is a right-to-left shunt or bronchial carcinoid. Treatment may require valve replacement in severe cases.
Usage
Usage note: Primarily affects right-sided heart valves; left-sided involvement suggests bronchial origin or cardiac shunt.
In Context
- "Echocardiography revealed severe tricuspid regurgitation consistent with carcinoid heart disease." — Cardiology consultation note
- "The patient developed carcinoid heart disease five years after initial carcinoid syndrome diagnosis." — Oncology follow-up note