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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report a case of carcinoid heart disease secondary to a tumour of the small bowel with liver metastases. There were severe lesions of the endocardium on the right side of the heart, with gross pulmonary and tricuspid incompetence. The left side of the heart did not escape but the fibrous plaques were limited to the papillary muscle of the mitral valve, and had no effect upon the haemodynamics. The pathogenesis of the strange cardiac lesion may be partly explained in terms of the toxicity to the endothelium of bradykinin. In spite of the serious nature of the valvular damage is it right to consider surgical correction, bearing in mind the fact that the prognosis of carcinoid syndrome is still very poor despite treatment?
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PMID:[Carcinoid heart disease secondary to a tumor of the small intestine. Apropos of a case with associated tricuspid and pulmonary insufficiency]. 14 56

A man with high urinary levels of 5-hydroxyindole acetic acid had an oat cell carcinoma of the bronchus. The patient had symptoms of the carcinoid syndrome and at autopsy was found to have evidence of carcinoid heart disease. This report supports the hypothesis that bronchial carcinoids and oat cell carcinomas are derived from argentaffin (Kulchitsky)-type cells of the lung.
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PMID:Oat cell carcinoma of the bronchus and the carcinoid syndrome. 17 51

The case is reported of carcinoid heart disease in a lady of 70 with intractable congestive cardiac failure 5 years after the removal of a primary carcinoid tumour of the ovary. The special features of primary carcinoid tumours of the ovary are recalled, with emphasis on their rarity and of the absence of liver metastases. The various features of carcinoid syndrome are recalled in the light of current knowledge of the pathogenesis. A review of the literature on cardiac involvement in primary carcinoid tumours of the ovary, amounting to 10 cases, is included. The possibility of surgical cure of the heart lesions in carcinoid tumour by a prosthetic tricuspid valve are discussed, in the light of the 6 reported cases and the present one. Our report is the first one of replacement of the valve after removal of a primary ovarien carcinoid tumour, and the excellent result has been maintained after three years.
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PMID:[Severe tricuspid insufficiency and primary carcinoid tumor of the ovary. Long term success after valve replacement. Apropos of a case]. 41 76

An ultrastructural and histochemical study of the subendocardial lesion in carcinoid heart disease showed six different cell types within a myxoid matrix. The matrix, composed of a mucopolysaccharidic ground substance, collagen, and reticluin fibers, contained stem cells, four types of fusiform cells (fibrocytes, fibroblasts, myofibroblasts, and smooth muscle cells), and intermediary cell type. Our observations suggest that the humoral mediators of the carcinoid syndrome may induce the differentiation of a subendocardial stem cell into contractile elements.
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PMID:Light and electron microscopic study of cellular proliferation in carcinoid heart disease. 120 7

We report the use of adrenaline in a 62-year-old woman with carcinoid heart disease who underwent double valve replacement. She was given an intravenous infusion of octreotide throughout the peri-operative period. Following the termination of cardiopulmonary bypass she developed profound hypotension which proved to be refractory to various therapies but responded to adrenaline. Adrenaline is said to be contraindicated in carcinoid syndrome, but we would suggest the consideration of its use in such cases where the hypotension may result from myocardial depression rather than from a carcinoid crisis.
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PMID:Hypotension following valve replacement surgery in carcinoid heart disease. 809 3

Right heart failure in patients with carcinoid heart disease is a serious prognostic sign. Consideration and adequate timing of valvular operations seem essential for the postoperative outcome. Without any relation to duration or progression of the metastasizing tumor disease, right heart failure developed and increased rapidly for a period of 12 to 17 months in four patients with classic carcinoid syndrome. Invasive hemodynamic and cardiac ultrasound investigations revealed severe carcinoid heart disease, and medical decompensation treatment gradually failed. Tricuspid and pulmonic valve replacement operations resulted in dramatic improvement in three of the patients, and these patients were still free of cardiac symptoms 10, 12, and 38 months postoperatively. One patient died 5 days postoperatively probably of septicemia. The preoperative and postoperative development of the cardiac disease is evaluated clinically, by cardiac ultrasound and plasma atrial natriuretic peptide concentrations, and related to the tumor disease. Surgical anatomy and operative technique are reported, and the beneficial value of prophylactic treatment of the effects of tumor-released vasoactive substances by a somatostatin analog is emphasized.
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PMID:Surgical treatment of carcinoid heart disease. 214 80

A pre-menopausal patient with a six-year history of symptoms of the metastatic carcinoid syndrome leading to progressively worsening carcinoid heart disease is described. The failure of anti-oestrogenic therapy (sequential bilateral oophorectomy and Tamoxifen therapy) to halt progression of disease was documented. Death resulted from right ventricular failure associated with pulmonary and tricuspid valvular disease.
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PMID:Malignant carcinoid syndrome. Failure of anti-oestrogenic therapy. 233 98

To correlate clinical and laboratory variables in carcinoid heart disease, clinical data, echocardiograms, 24-hour urinary 5-hydroxyindoleacetic acid levels and liver function tests were evaluated in 30 patients with the carcinoid syndrome. The dominant cardiac lesion of carcinoid heart disease by echocardiography and Doppler was severe tricuspid regurgitation with right ventricular volume overload. A characteristic finding was thickened, retracted tricuspid valve leaflets that were fixed in a partially open position. Carcinoid heart disease was progressive and often fatal. The 17 patients with echocardiographic evidence of carcinoid heart disease had higher peak levels of urinary 5-hydroxyindoleacetic acid (331 +/- 231 vs 58 +/- 78 mg, p less than 0.001) and more severe hepatic dysfunction than the 13 patients without carcinoid heart disease. Although duration of symptoms of the carcinoid syndrome before echocardiography was similar for patients with and without carcinoid heart disease (5.4 +/- 6.4 vs 6.2 +/- 5.9 years, respectively, p greater than 0.1), survival after echocardiography was shorter for those with carcinoid heart disease (1.9 +/- 1.4 vs 3.8 +/- 2.9 years, p = 0.05). The findings support the concept that long-term exposure of the endocardium to serotonin in the right side of the heart leads to the development of heart lesions; in addition, progressive hepatic dysfunction may allow more serotonin to bypass liver enzymes and reach the right side of the heart.
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PMID:Clinical and echocardiographic comparison of patients with the carcinoid syndrome with and without carcinoid heart disease. 246 78

The clinical manifestations of the carcinoid syndrome have been known for 35 years. Median survival in patients with carcinoid syndrome, although dependent on several factors, including the extent of liver metastases, is in the range of four years. In this setting, a frequent cause of death is right-sided cardiac dysfunction. When this occurs, the only definitive palliation is surgical in patients with this slow-growing tumor. Successful palliation was provided by tricuspid valve replacement and pulmonary valvoplasty in a patient with carcinoid heart disease and extensive liver metastases. This emphasizes the importance of surgery in selected patients with this slow-growing tumor.
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PMID:Palliation of carcinoid heart disease. 361 23

Carcinoids are solid tumours arising from enterochromaffin cells, usually of the gastrointestinal or respiratory tract. They are fairly common, and in autopsy series have been present in up to 1% of cases. In contrast the carcinoid syndrome--the combination of flushing, diarrhoea, wheezing and heart disease due to release of vasoactive substances from these tumours--is rare. One estimate is that in a population of 250 000 over 10 years only two new cases would arise (Linell and Mansson, 1966).
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PMID:Carcinoid syndrome. Medical management. 374 26


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