TRICUSPID AND PULMONARY VALVE INVOLVEMENT IN CARCINOID SYNDROME. REPORT OF TWO CASES

Síndrome carcinoide y compromiso valvular cardiaco, a propósito de 2 casos.

Author
Paredes, Alejandro; Pontificia Universidad Católica de Chile

Valdebenito, Martin; Pontificia Universidad Católica de Chile

Gabrielli, Luigi; Pontificia Universidad Católica de Chile

Castro, Pablo; Pontificia Universidad Católica de Chile

Zalaquett, Ricardo; Pontificia Universidad Católica de Chile

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http://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/view/3245
Abstract
Carcinoid is a rare neuroendocrine tumor typically arising in the gastrointestinal tract that can cause heart valve involvement. We report two patients with carcinoid syndrome and tricuspid/pulmonary valve lesions. A 33 years old male presenting with fatigue and weight loss: A tumor in the tail of the pancreas was found on an abdominal CAT scan. The percutaneous biopsy was informed as a carcinoid tumor. A trans-esophageal echocardiogram showed a tricuspid and pulmonary valve involvement, which was replaced surgically. The biopsy informed an extensive fibrous and myxoid degeneration of the valves. A 35 years old male with a carcinoid syndrome and cardiac failure: An echocardiogram showed a severe tricuspid stenosis and severe pulmonary regurgitation. The patient was subjected to a double surgical valve replacement. The pathology report of the excised valve showed a deforming fibrous and myxoid valvulopathy.
 
Abstract Carcinoid is a rare neuroendocrine tumor tipically originates in the gastrointestinal tract and which may result in a broad spectrum of symptoms mediated by vasoactive substances. In over half the cases, can exist cardiac valve involvement, tricuspid and pulmonary mainly, which determins right heart failure, increasing morbidity and mortality of the disease. A multidisciplinary approach at an experienced center is recommended for this type of patient. We report two cases of patients with carcinoid syndrome with cardiac valve involvement, describing its history and management. Resumen El carcinoide es un tumor neuroendocrino raro que se origina típicamente en el tracto gastrointestinal y que puede resultar en un amplio espectro de síntomas mediado por sustancias vasoactivas. En más de la mitad de los casos, puede existir compromiso valvular cardiaco principalmente tricuspídeo y pulmonar, lo que determina insuficiencia cardiaca derecha, aumentando la morbimortalidad de la patología. Se recomienda un enfoque multidisciplinario en un centro de experiencia para este tipo de pacientes. Reportamos 2 casos de pacientes portadores de síndrome carcinoide con compromiso valvular cardiaco, describiendo su historia y manejo.
 
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