Morphologic Features of Carcinoid Heart Disease as Assessed by Three-Dimensional Transesophageal Echocardiography

Background: Carcinoid heart disease (CHD) is a rare cause of valvular heart disease and carries a poor prognosis. CHD has a unique morphology and echocardiographic features that predominantly involve right‐sided valvular structures. The diagnosis of CHD is usually made by two‐dimensional transthorac...

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Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2010-10, Vol.27 (9), p.1098-1105
Main Authors: Nalawadi, Smruti S., Siegel, Robert J., Wolin, Edward, Yu, Run, Trento, Alfredo, Shiota, Takahiro, Tolstrup, Kirsten, Luthringer, Daniel, Gurudevan, Swaminatha
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Carcinoid Heart Disease - diagnostic imaging
Echocardiography, Three-Dimensional - methods
Echocardiography, Transesophageal - methods
Female
Humans
Male
Middle Aged
three-dimensional transesophageal echocardiography
transesophageal echocardiography
tricuspid regurgitation
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Summary:Background: Carcinoid heart disease (CHD) is a rare cause of valvular heart disease and carries a poor prognosis. CHD has a unique morphology and echocardiographic features that predominantly involve right‐sided valvular structures. The diagnosis of CHD is usually made by two‐dimensional transthoracic echocardiography (TTE). With the superior spatial resolution of real time three‐dimensional transesophageal echocardiography (3DTEE), structural changes that occur in patients with CHD‐associated valvular heart disease can be examined in greater detail. We undertook this study to examine the incremental value of 3DTEE in the diagnosis of CHD. Methods: A total of four patients with CHD underwent TTE, transesophageal echocardiography (TEE), and 3DTEE as part of their routine clinical evaluation. Results: TTE and TEE for all four patients revealed thickened, fibrosed, retracted, and malcoapted tricuspid leaflets with wide‐open tricuspid valve regurgitation. 3DTEE en face imaging of the tricuspid valve demonstrated the characteristic morphologic features of CHD more clearly in all four patients. Conclusions: 3DTEE provides substantial incremental value over TTE in the assessment of characteristic CHD pathology and thus enhances the echocardiographic diagnosis of CHD. (Echocardiography 2010;27:1098‐1105)
ISSN:0742-2822
1540-8175
DOI:10.1111/j.1540-8175.2010.01207.x