Carcinoid syndrome echocardiography or ultrasound
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Trans-thoracic echocardiography findings include thickening and retraction of immobile tricuspid valve leaflets with associated tricuspid regurgitation and immobility of the pulmonary valve cusps. Trans-esophageal echocardiography findings provide incremental assessment of the degree of cardiac valve involvement and the atrial septal anatomy in patients with carcinoid heart disease.
- Should be performed in all patients with carcinoid syndrome and high suspicion of carcinoid heart disease such as clinical features or raised NT-proBNP and/or 5-HIAA levels.
- Findings includes followings:
- Thickening and retraction of immobile tricuspid valve leaflets with associated tricuspid regurgitation, which is severe at the time of identification in 90 percent of patients.
- Immobility of the pulmonary valve cusps.
- TEE is primarily used intraoperatively to image the patient with carcinoid heart disease during valve replacement surgery.
- TEE may provide incremental assessment of the degree of cardiac valve involvement and the atrial septal anatomy in patients with carcinoid heart disease.
Cardiac magnetic resonance
- It can be used to evaluate the pulmonary valve, identify cardiac metastases, and assess right ventricular size and function.
- Pellikka PA, Tajik AJ, Khandheria BK, Seward JB, Callahan JA, Pitot HC, Kvols LK (April 1993). "Carcinoid heart disease. Clinical and echocardiographic spectrum in 74 patients". Circulation. 87 (4): 1188–96. PMID 7681733.
- Stougiannos, Pavlos; Michas, George; Evdoridis, Constantinos; Arapantoni-Dadioti, Petroula; Tolios, Panagiotis; Kaplanis, Ioannis; Trikas, Athanasios (2017). "Carcinoid heart disease in an elderly female patient: the value of transthoracic echocardiography". Hellenic Journal of Cardiology. 58 (1): 65–68. doi:10.1016/j.hjc.2017.01.018. ISSN 1109-9666.
- Banzali, Franklin M.; Tiwari, Anil K.; Frantz, Robert; D’Attellis, Nicola (2007). "Valvular Heart Disease Caused by Carcinoid Syndrome: Emphasis on the Use of Intraoperative Transesophageal Echocardiography". Journal of Cardiothoracic and Vascular Anesthesia. 21 (6): 855–857. doi:10.1053/j.jvca.2007.06.014. ISSN 1053-0770.
- Bastarrika G, Cao MG, Cano D, Barba J, de Buruaga JD (2005). "Magnetic resonance imaging diagnosis of carcinoid heart disease". J Comput Assist Tomogr. 29 (6): 756–9. PMID 16272847.