Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The carcinoid syndrome is a result of the release of multiple carcinoid tumor factors, particularly serotonin, kinins, and histamine. These factors cause flushing, hemodynamic instability, right-sided heart disease, bronchospasm, and gastrointestinal symptoms. A through preoperative assessment concentrating on these areas is necessary. The use of invasive monitors perioperatively, with the avoidance of drugs and techniques that can exacerbate the syndrome, is beneficial. Octreotide, both prophylactically and acutely, provides the best medical therapy available.
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PMID:Update on carcinoid syndrome. 923 98

Hypertrophic obstructive cardiomyopathy (HOCM), the cause of which is unknown, is a heart disease characterized by obstruction of the left ventricular outflow tract and an increase in interventricular septum thickness. Octreotide, a synthetic analogue of somatostatin, was administered subcutaneously to 15 patients for 6 months in order to determine its efficacy in HOCM. Echocardiographic examination was performed in each patient before we had initiated treatment and after treatment. Interventricular septum thickness, interventricular septum thickness/left ventricular posterior wall thickness, and subaortic gradient decreased significantly at the end of treatment. The ratio of the mitral valve E to A waves increased significantly. We observed that octreotide treatment caused a significant decrease in interventricular septum thickness and subaortic pressure gradient. Before and after therapy left ventricular enddiastolic diameter, left ventricular endsystolic diameter, ejection fraction and fractional shortening were not changed. No adverse effect was observed during the therapy. According to our results, octreotide has some beneficial effects on HOCM and it seems to be a new therapeutic approach for HOCM.
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PMID:Effects of octreotide in patients with hypertrophic obstructive cardiomyopathy. 968 26

We report on the case of a 34-year-old male patient suffering from end-stage carcinoid heart disease with severe tricuspid, pulmonary and mitral valve regurgitation. In addition, a persisting foramen ovale was present. The primary carcinoid tumor was never discovered. However, urine 5-hydroxy-indole-acetic-acid (5-HIAA) were consistently elevated after the first diagnosis of carcinoid disease and after eight years of medication with Octreotide and Interferon alpha-2b our patient developed significant cardiac insufficiency mainly due to severe valvular dysfunction. Ultimately, mechanical tricuspid, mitral and pulmonary valve replacement was performed. Twelve hours following the operation the patient had to be returned to the operating room for persisting intrathoracic hemorrhage. He recovered uneventfully and was discharged from hospital on day 37. Twelve months following triple valve replacement the cardiac status recovered from preoperative NYHA-IV to NYHA-I.
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PMID:Triple valve replacement in a patient with severe carcinoid heart disease. 1204 40

Patients with carcinoid tumours frequently present with metastatic disease. There are only a few therapeutic options for these patients, and the main goal of palliative treatment is to reduce symptoms and thus to improve quality of life. Current therapy includes surgical resection, hepatic artery embolisation, chemotherapy and somatostatin analogue treatment; however, all these options have limitations. It seems probable that therapeutic modalities based on radiopharmaceuticals may provide better therapy, not only in relation to symptom reduction but may also improve patient survival. In this case report we present a 46-year-old woman with a symptomatic carcinoid, who at the time of diagnosis had liver and abdominal lymph node metastases, the primary tumour being located in the terminal ileum. (111)In-pentetreotide scanning was negative, whereas (123)I-MIBG scanning showed high avidity in the tumour tissue. After right hemicolectomy, two courses of (131)I-MIBG treatment were given (12.95 GBq and 12 GBq, respectively). After the second dose of (131)I-MIBG temporary pancytopenia was present. Octreotide therapy was given empirically only for a short time and was stopped because of drug intolerance. The patient underwent tricuspid and pulmonary valve replacement because of her carcinoid heart disease, followed by two courses of embolisation of liver metastases. While (131)I-MIBG therapy reduced the patient's symptoms of flushing and diarrhoea, there has not yet been any effect on tumour response or 5-HIAA production. This case illustrates the multimodality and multidisciplinary approach to such patients.
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PMID:Multimodality palliative treatment of (111)In-pentetreotide negative/(123)I-MIBG positive metastatic carcinoid - a case report. 1877 5

A 70-year-old female with severe tricuspid regurgitation and stenosis was admitted to our institution because of watery diarrhea and peripheral edema. The urinary 5-hydroxyindoleacetic acid (5-HIAA) level was 292.9 mg/l (normal, 0.5-5.0 mg/l). Abdominal computed tomography showed enhanced multiple nodules in the liver. The liver biopsy revealed metastatic carcinoid disease, which was thought as an etiology in severe tricuspid regurgitation and stenosis. We administered long acting somatostatin analog, octreotide to control carcinoid symptoms. After improvement of general condition, she successfully underwent bioprosthetic valve replacement with concomitant octreotide administration. Postoperative course was uneventful. She had been followed up with administration of octreotide at outpatient clinic. Cardiac surgery for carcinoid heart disease is complicated by hemodynamic instability secondary to carcinoid crises which can be provoked pharmacologically by administration of vasoactive medications. Octreotide is an effective tool to manage manifestation of carcinoid activity. We could performed surgical treatment of carcinoid heart disease safely in the perioperative presence of octreotide.
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PMID:[Surgical treatment of carcinoid heart disease]. 2095 58

Octreotide is a somatostatin analogue used to control upper gastrointestinal bleeding. We report a case of a patient with no significant cardiac history who had multiple asystolic events during an octreotide infusion at a relatively low dose. Although octreotide leading to bradycardia and heart block has been documented in several case reports, to our knowledge, octreotide-associated asystole has not been described. It is pertinent that physicians must be aware of this significant cardiac effect for vigilant cardiac monitoring and management, preferably in an intensive care setting. Furthermore, this suggests that although dose- and route-related effects have been described, some individuals may be susceptible at low doses, even in the absence of heart disease. There were no further recurrences after the drug was discontinued.
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PMID:Octreotide-induced asystolic events in an intensive care unit patient with gastrointestinal bleeding. 2265 68