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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

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

Decreased serum albumin levels are commonly observed in patients with carcinoid tumor, who also show several characteristic clinical and biochemical abnormalities. A large comparative study on a group of 96 carcinoid patients was performed with the purpose of identifying some of the mechanisms leading to hypoalbuminemia in patients with this form of cancer, and thereby to shed light on the cause of hypoalbuminemia of cancer in general. Serum albumin values were compared with a number of clinical parameters (including extent of liver metastases, severity of diarrhea, degree of right heart failure, and extent of gastrointestinal surgery) and of laboratory data (prothrombin time, BSP retention, serum transferrin concentration, hematocrit value, and daily urine excretion of 5-hydroxy-indoleacetic acid). In several patients the gastrointestinal protein loss was assessed by the 51Cr-albumin technique, whereas albumin renewal and distribution were evaluated by the use of 125I-albumin. The data obtained showed that the main factors in determining decreased serum albumin levels in patients with carcinoids are both reduced synthesis and increased loss of the protein. The hepatic synthetic defect appears to be related to a progressive decrease in the number of functioning liver cells; the origin of the gastrointestinal protein loss may be related to the obvious tumor involvement of the gut wall, as well as to the pharmacologically-induced diarrhea. Right heart failure occurring as a result of the carcinoid heart disease may be an additional cause for gastrointestinal protein loss in patients with carcinoid tumor.
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PMID:Pathophysiology of hypoalbuminemia associated with carcinoid tumor. 97 3

Sonography and duplex Doppler frequently fail to identify a cause for right upper quadrant pain, liver dysfunction, or ascites. The aim of our study was to describe and analyze the pulsatile portal venous waveform in which minimum velocity dropped to or below zero on duplex Doppler sonography and to investigate its possible association with tricuspid regurgitation, one of the causes of liver dysfunction. We correlated the findings in 15 patients in whom this duplex Doppler waveform was seen with the findings on Doppler echocardiography (n = 14) or ultrafast CT (n = 1). All patients had biochemical liver abnormalities or sudden onset of ascites, rapid weight gain, increased abdominal girth, and hepatomegaly. They were referred for sonography to rule out liver metastases, biliary disease, portal vein thrombosis, or Budd-Chiari syndrome. All examinations were done with a 3-MHz phased-array sector transducer with duplex Doppler capability. Seventeen volunteers with no known liver or heart disease served as a control group. We correlated maximum and minimum flow velocities on the portal venous Doppler waveform with the portal vein diameters of the study and control groups. Thirteen patients were later proved to have tricuspid regurgitation, one patient had an aortic-right atrial fistula owing to rupture of an aneurysm of the sinus of Valsalva, and one patient was proved to be normal. In none of the 17 control subjects was this pulsatile portal venous waveform seen. Our study shows that detection of a pulsatile portal venous waveform on duplex Doppler sonography in patients with liver dysfunction should raise the possibility of tricuspid regurgitation.
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PMID:Pulsatile portal vein flow: a sign of tricuspid regurgitation on duplex Doppler sonography. 211 8

A case of carcinoid cardiopathy (C.C.) of the right heart, related to liver metastases secondary to a bronchial tumor, is reported. Non-invasive investigative methods have enabled an easy diagnosis of C.C.: liver metastases by scan and abdominal sonogram, restrictive myocardiopathy with typical tricuspid lesions by echocardiography and MRI, magnitude of the tricuspid regurgitation by cardiac Doppler. These extremely performing methods must allow an early diagnosis at a stage when the patient may be still operable, since C.C. is the most frequent cause of death in patients with carcinoid tumors.
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PMID:[Carcinoid cardiopathy: value of ultrasonography and MRI. Apropos of a case related to bronchial tumor. Review of the literature]. 265 Jun 11

The chest films of 44 patients with liver metastases from intestinal carcinoid tumors were reviewed in order to evaluate the frequency of significant carcinoid heart disease. Only two patients had obvious signs of cardiac involvement, which is contradictory to most other studies.
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PMID:Chest radiography in the carcinoid syndrome. 295 41

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

A woman with tricuspid regurgitation due to carcinoid heart disease underwent successful tricuspid valvular replacement. This was performed as soon as the patient became symptomatic, enabling her to return to a normal life untroubled by slowly growing liver metastases. Few early valvular replacements have been undertaken in this disease. This case report demonstrates its usefulness.
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PMID:Cardiac valvular replacement in carcinoid heart disease. 663 58

This case report describes the echocardiographic documentation of a 60 year old patient with tricuspid regurgitation due to carcinoid heart disease. The carcinoid syndrome was histologically proven by liver metastases and by an increased 5-hydroxytryptamin secretion. Tricuspid involvement was echocardiographically documented by immobile, thickened leaflets. Diffuse endocardial thickening of the right chamber and pulmonary valve involvement was absent.
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PMID:[Echocardiographic detection of tricuspid insufficiency in carcinoid heart syndrome - case report]. 715 23

The extent of heart disease and its relationship to the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA), was studied with M-mode, 2D and Doppler echocardiography in 42 consecutive patients, 30 females and 12 males, median age 63 (range 23-75) years with histologically verified mid-gut tumour, liver metastases and 24-h urinary 5-HIAA excretion above 47 mumol.24 h-1. All patients had normal left ventricular ejection fractions, median 65% (interquartile range (IQR) 54-74%). Moderate to severe tricuspid regurgitation (TR) was diagnosed in 22 patients (59%); mitral or aortic regurgitation was found in nine (24%) and six (16%) patients, respectively. The mitral flow peak early (E) on late (A) velocity ratio was significantly decreased compared to age-matched normal subjects. The group of patients with 5-HIAA excretion exceeding 1000 mumol.24h-1 contained significantly more patients with severe TR than those with a lower excretion. The decrease in the E/A ratio may indicate reduced left ventricular compliance, possibly secondary to fibrous changes similar to those seen intra-abdominally and in the right side of the heart. As serotonin is degraded in the lung circulation, other mediators such as tachykinins and cytokines (PDGF) may be involved.
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PMID:Cardiac manifestations in mid-gut carcinoid disease. 753 79


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