e16218 Background: Carcinoid is a well differentiated neuroendocrine tumor (NET) arising most commonly in the gastrointestinal tract or bronchopulmonary system. Carcinoid syndrome is a constellation of symptoms mediated by a myriad of vasoactive substances elaborated by the Carcinoid tumor, of which serotonin is most prominent in the pathophysiology of Carcinoid heart disease (CHD). CHD is characterized by pathognomonic plaque-like deposits of fibrous tissue on the endocardium of valvular cusps, leaflets, papillary muscles and cords. Clinical manifestations include valvular heart disease(VHD), arrhythmias and coronary heart disease. We aim to determine the impact of co-existing VHD in patients with CHD on morbidity, mortality, length of stay and mean hospitalization costs as compared to patients without coexisting VHD. Methods: We identified hospitalized adult patients with Carcinoid syndrome and divided them into patients with and without VHD from October 2015 to December 2018 from the National Inpatient Sample Database using ICD 10 Codes. We further determined demographics, baseline characteristics, associated comorbidities, mortality, length of stay (LOS) and hospitalization costs among patients with carcinoid syndrome with and without documented VHD. SAS 9.4 software was used for statistical analysis. Results: We captured 10,135 patients hospitalized with carcinoid syndrome, amongst which 705 patients were found to have VHD. The group with VHD were predominantly males (51.8 vs 48.2%), had a higher prevalence of CAD (26.2 vs 16.8%), heart failure with reduced ejection fraction(17.7 vs 3.7%), heart failure with preserved ejection fraction (13.5 vs 6%), atrial fibrillation (28.4 vs 15.3%), pleural effusion (13.5 vs 7.1%), pericardial effusion (2.8 vs 1%) as compared with patients without VHD. They were also noted to have higher inpatient mortality (9.2 vs 5.2%), length of stay (8.8 vs 6.6 days) and mean hospitalization cost (31973 vs 17734$). In the cohort with CHD and co-existing VHD, we noted mortality was highest amongst patients with involvement of pulmonary valve (13.5%) followed by tricuspid, mitral and aortic valves(13%, 8.3% and 4% respectively). Conclusions: Carcinoid tumor involves the heart in about 60% of the patients and is associated with poor long-term prognosis and is a major cause of morbidity and mortality. With mounting epidemiological evidence of poor outcomes in patients with carcinoid syndrome and VHD, our study shines light on the importance of a concerted effort to develop an algorithm for early screening, diagnosis and treatment of CHD. This necessitates multidisciplinary approach control of progressive heart failure, treatment of systemic malignancy and surgical correction of right sided valvular heart disease by utilizing services of a team consisting of surgeons, oncologists and cardiologists to guide management.