Carcinoid heart

Cardiac involvement in patients with neuroendocrine tumours affects sixty-five per cent of those with carcinoid syndrome. It carries a poor prognosis and may, on its own, account for forty per cent of mortality. This is why early diagnosis of this condition is so important. Echocardiography can sometimes suggest the diagnosis; it also enables the monitoring of cardiac involvement and helps guide treatment. The aim of this paper is to provide an update on carcinoid heart disease, based on two observations. The contribution of 3D echocardiography compared with 2D echocardiography is primarily illustrative in the case of cardiac lesions that are already manifest. Furthermore, at an early stage, 3D echocardiography may reveal the deposition of fibrous plaques on the endocardium of the right-sided valves or cardiac chambers. The reversibility of cardiac lesions following appropriate cancer treatment has not been demonstrated. It is therefore clear that the early diagnosis of carcinoid heart disease is a priority justifying repeat echocardiograms and the use of 3D imaging. However, these points must first be borne in mind.