UMEM Educational Pearls

Category: Critical Care

Title: Carcinoid-induced Heart Failure

Posted: 5/21/2012 by Haney Mallemat, MD (Emailed: 5/22/2012) (Updated: 5/22/2012)
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Carcinoid tumors are neuroendocrine malignancies typically located in the GI tract; most commonly in the terminal ilium and appendix.

Carcinoid tumors produce serotonin, histamine, bradykinin, and/or prostaglandin that result in diarrhea, facial flushing, or bronchospasm. These vasoactive substances may also lead to hypotension and vasodilatory shock.

The tumor may also affect the tricuspid and pulmonary valves leading to right-heart failure secondary to valvular regurgitation, stenosis or both.

Treatment is directed at controlling the malignancy (e.g., octotrotide and tumor resection) as well as managing the right-sided heart failure when it occurs (e.g., inotropes, diuretics, vasopressors, etc.).



Fox, D. J. (2004). Carcinoid heart disease: presentation, diagnosis, and management. Heart, 90(10), 1224–1228

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