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carcinoid heart disease

Tuesday 5 May 2009

Nearly 40% of patients exhibiting carcinoid syndrome develop carcinoid heart disease (CHD) with fibrotic endocardial plaques and associated heart valve dysfunction that classically involves the tricuspid valve.

Advanced changes in tricuspid valvular disease have been shown to be associated with poor long-term survival, and carcinoid valvular disease, rather than tumor dissemination, is the cause of death in approximately one third of these patients.

Though the mechanism behind CHD is not fully understood, serotonin is presumed to be the catalyst for the cardiac fibrotic process based on murine in vivo models of CHD.

Nearly 95% of patients present with right-sided heart valve disease, characterized by tricuspid insufficiency and pulmonary stenosis (the so called TIPS process) and the subsequent development of pulmonary hypertension.

Left-sided cardiac disease may be seen in up to 10% of patients, as is commonly associated with angina and coronary vasospasm.

See also

- carcinoid tumors
- carcinoid syndrome