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European Journal of Echocardiography 2007 8(5):386-389; doi:10.1016/j.euje.2006.04.008
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Copyright © 2006, The European Society of Cardiology

Carcinoid crisis and reversible right ventricular dysfunction after embolization in untreated carcinoid syndrome

Farhan Majeed*, Thomas R. Porter, Stefano Tarantolo, Amy Duhachek-Stapelman, Feng Xie and Abdou Elhendy

University of Nebraska Medical Center, Department of Internal Medicine, 982055 Nebraska Medical Center, Omaha, NE 68198-2055, United States

Received 3 May 2005; received in revised form 27 March 2006; accepted after revision 14 April 2006.

farhanmajeed1{at}yahoo.com

* Corresponding author. Tel.: +1 410 328 4394.


  Abstract

A 59-year-old white male with carcinoid tumor and hepatic metastases underwent hepatic artery embolization. The patient developed carcinoid crisis and a subsequent transthoracic echocardiogram showed classic findings of carcinoid heart disease along with a dilated hypertrophied right ventricle and severely depressed right ventricular ejection fraction. After treatment with octreotide the patient's clinical condition improved and a repeat transthoracic echocardiogram showed a significant improvement and normalization of right ventricular systolic function. Serotonin levels showed a progressive decline that correlated well with the patient's improved clinical condition. These findings suggest that the acute right ventricular dysfunction was secondary to acute carcinoid crisis and resolution resulted in a significant improvement of both right ventricular systolic function and clinical condition.

Keywords: Carcinoid crisis; Right ventricle; Serotonin


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