Two- and Three-dimensional Imaging in Carcinoid Heart Disease

Abstract

Abstract A 70-year-old male presented with a history of pedal edema, abdominal distension, and dyspnea on exertion New York Heart Association Class III for cardiology evaluation. He was a known case of a neuroendocrine tumor of the small intestine diagnosed 3 years back and was on octreotide injection monthly for 20 months, now presented with features of the right heart failure. Transthoracic echocardiography showed thickened shortened immobile tricuspid valve leaflet with severe tricuspid regurgitation, and transesophageal echocardiography also confirmed the same. Three-dimensional (3D) echocardiography showed a tricuspid valve thickened and retracted with restricted mobility called a club-shaped leaflet, and with this, a diagnosis of carcinoid heart disease was made. This case mainly aims at stressing the need for early echo in neuroendocrine patients, which helps with early diagnosis and intervention to improve their survival significantly, and the application of 3D echo which will provide detailed anatomical information, particularly if tricuspid and pulmonary valves are involved.