Carcinoid cardiac lesions
There is thickening of mural and valvular endothelial surfaces of right-sided cardiac structures. This is thought to occur as a response to circulating neuroendocrine substances (serotonin, bradykinin, histamine, prostaglandin, etc) released into the bloodstream by the original carcinoid tumour.
The lesions typically affect the right heart valves (tricuspid and pulmonary) and endocardial surfaces of right sided chambers. This is primarily a reflection of relative occurrence of original carcinoid tumours (e.g. bowel). Left sided valve lesions can occur with primary bronchial carcinoid or in those with a right to left shunt (e.g. patent foramen ovale).
- consider in the case of isolated tricuspid or pulmonary valve lesions
- may shows thickened, retracted valves 1,4
- often fixed with minimal movement during the cardiac cycle 1,4
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- 3. Veitch AM, Morgan-Hughes GJ, Roobottom CA. Carcinoid heart disease as shown by 64-slice CT coronary angiography. Eur. Heart J. 2006;27 (19): 2271. doi:10.1093/eurheartj/ehi848 - Pubmed citation
- 4. Mirowitz SA, Gutierrez FR. MR and CT diagnosis of carcinoid heart disease. Chest. 1993;103 (2): 630-1. Pubmed citation
- 5. Fox DJ, Khattar RS. Carcinoid heart disease: presentation, diagnosis, and management. Heart. 2004;90 (10): 1224-8. doi:10.1136/hrt.2004.040329 - Free text at pubmed - Pubmed citation