Cardiac Imaging in Carcinoid Heart Disease

JACC Cardiovasc Imaging. 2021 Nov;14(11):2240-2253. doi: 10.1016/j.jcmg.2020.12.030. Epub 2021 Apr 14.

Abstract

Carcinoid disease is caused by neuroendocrine tumors, most often located in the gut, and leads in approximately 20% of cases to specific, severe heart disease, most prominently affecting right-sided valves. If cardiac disease occurs, it determines the patient's prognosis more than local growth of the tumor. Surgical treatment of carcinoid-induced valve disease has been found to improve survival in observational studies. Cardiac imaging is crucial for both diagnosis and management of carcinoid heart disease; in the past, imaging was accomplished largely by echocardiography, but more recently, imaging for carcinoid heart disease has increasingly become multimodal and warrants awareness of the particular diagnostic challenges of this disease. This paper reviews the pathophysiology and manifestations of carcinoid heart disease in light of the different imaging modalities.

Keywords: carcinoid disease; multimodality imaging; pulmonary regurgitation; tricuspid regurgitation; valvular heart disease.

Publication types

  • Review

MeSH terms

  • Carcinoid Heart Disease* / diagnostic imaging
  • Carcinoid Heart Disease* / surgery
  • Echocardiography
  • Humans
  • Predictive Value of Tests
  • Prognosis