Abstract
This is a case report of a 75-year-old patient with a pelvic carcinoid tumour who had valve replacements and a patent foramen ovale repair. Her postoperative course was complicated by persistent symptoms related to the carcinoid tumour. Pathophysiology and management are reviewed. Cardiac surgery for carcinoid heart surgery has significantly high morbidity and mortality. Common complications include cardiovascular instability, bronchospasm, complete heart block, gastrointestinal hypermotility and acute kidney injury. Acute pulmonary oedema can be a presenting feature of a carcinoid crisis and should be suspected in the differential diagnoses of pulmonary oedema in carcinoid heart disease patients. Octreotide remains the mainstay of treatment. Doses of up to a maximum of 200 μg/hour can be used. There is emerging evidence that catecholamines can be used safely when used in conjunction with octreotide. Good analgesia is important in suppressing sympathetic stimulation.
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