AnatomyDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPhenomena and ProcessesHealth Care
Carcinoid Heart DiseaseCarcinoid TumorMalignant Carcinoid SyndromeTricuspid Valve StenosisHeartHeart ValvesHydroxyindoleacetic AcidHeart Valve DiseasesTricuspid Valve InsufficiencyTricuspid ValveHeart RateHeart DiseasesPulmonary ValveHeart Defects, CongenitalBioprosthesisEchocardiographyHeart FailureCoronary DiseaseIleal NeoplasmsHeart TransplantationFollow-Up StudiesRheumatic Heart DiseaseBronchial Neoplasms
TumorUnderlying carcinoid syndromeMetastaticSecreted by carcinoid tumorsManagement of patients with carcinoidValvular heart dSymptomsCardiacNeuroendocrine cellsSerotoninIntestinal carcinoidMitralTumors originateTricuspid valve replacementPatientsSyndromesSurgicalEtiologyAsymptomaticDiagnosisMetastases2022LiverAcuteFlushingOccursCardiovascularSevereGastrointestinal tractSecondaryClinicalSubstancesPrevalenceSystemicCongenital Heart DLung2023Syndrome developsLesionsValve Disease
Tumor26
  • Carcinoid heart disease (CHD) is a rare and potentially lethal manifestation of an advanced carcinoid (neuroendocrine) tumor. (karger.com)
  • We report the gratifying response of functioning metastatic neuroendocrine tumor with carcinoid heart disease (uncontrolled by long-acting octreotide) to treatment with 177 Lu-DOTATATE. (snmjournals.org)
  • A 30-y-old man who had been diagnosed with a grade II jejunal neuroendocrine tumor metastatic to the liver and abdomen was found clinically and on 2-dimensional (2D) echocardiography to have the complication of carcinoid heart disease. (snmjournals.org)
  • Malignant carcinoid syndrome occurs in fewer than 10% of patients with a carcinoid tumor. (medscape.com)
  • Follow-up assays of other bioactive substances vary according to the location of the carcinoid tumor. (medscape.com)
  • The somatostatin analogs (SSAs) octreotide and lanreotide are used to control carcinoid symptoms and tumor progression in advanced inoperable disease. (medscape.com)
  • This is why carcinoid syndrome most often occurs in patients whom the neuroendocrine tumor has metastasized to the liver, which allows the substances to bypass the first pass metabolism. (wikipedia.org)
  • Carcinoid heart disease is the result of valvular damage related to the vasoactive substances released by the neuroendocrine tumor reaching the right side of the heart. (wikipedia.org)
  • This mainly affects the right side of the heart unless there is anomalous circulation (i.e. patent foramen ovale) because the lungs will metabolize the substances released by the tumor similar to how the liver will. (wikipedia.org)
  • A symptom complex associated with CARCINOID TUMOR and characterized by attacks of severe flushing of the skin, diarrheal watery stools, bronchoconstriction, sudden drops in blood pressure, edema, and ascites. (harvard.edu)
  • Carcinoid tumors share some properties with other cancer cells such as uncontrolled, overproduction of the cells that results in tumor formation and malignant potential. (medifocus.com)
  • However, carcinoid tumor cells are distinguished from most other types of tumors in that they secrete various hormone-like substances (e.g., serotonin, noradrenalin, histamines) which may cause symptoms throughout the body rather than symptoms localized to the organ where the tumor originates. (medifocus.com)
  • According to the American Society of Clinical Oncology (ASCO), approximately 11,500 people in the United States are diagnosed each year with a carcinoid tumor. (medifocus.com)
  • The age at diagnosis varies somewhat among specific tumor locations but typically, most people diagnosed with a carcinoid tumor are in their 50s. (medifocus.com)
  • Symptoms are often associated with the site of tumor origin and reflect the tumor obstructing organs involved in normal body function but may be less specific if related to carcinoid syndrome. (medifocus.com)
  • The prognosis (outlook or chance of recovery) for patients with carcinoid tumors is based primarily on size of the tumor and the degree to which it has spread and invaded other tissues in the body. (medifocus.com)
  • However, given the patient's history of metastatic neuroendocrine tumor, as well as an elevated pro-BNP with echocardiographic evidence of severe tricuspid regurgitation, carcinoid heart disease is the most likely cause. (acc.org)
  • Metastatic carcinoid tumor to the heart: echocardiographic-pathologic study of 11 patients. (acc.org)
  • Rarely, a carcinoid tumor leaks chemicals into the bloodstream and causes skin flushing, lesions, shortness of breath, and bowel changes. (bewellbuzz.com)
  • The syndrome results from vasoactive substances (including serotonin , bradykinin, histamine, prostaglandins, polypeptide hormones) secreted by the tumor, which is typically a metastatic intestinal carcinoid. (msdmanuals.com)
  • An intestinal carcinoid does not usually cause carcinoid syndrome unless hepatic metastases have occurred because metabolic products released by the tumor are rapidly destroyed by blood and liver enzymes in the portal circulation (eg, serotonin by hepatic monoamine oxidase). (msdmanuals.com)
  • however, even if a carcinoid tumor produces these molecules, some patients do not experience any symptoms. (medscape.com)
  • Patients with poorly differentiated neuroendocrine carcinoma, high-grade neuroendocrine carcinoma without specification of differentiation status, adenocarcinoid tumor, or goblet cell carcinoid tumor are not eligible. (stanford.edu)
  • A carcinoid tumor that shows atypical characteristics and has borderline malignant potential. (nih.gov)
  • Carcinoid tumor. (nih.gov)
  • The Big Apple Noids support group invites you to join fellow carcinoid and neuroendocrine tumor (NET) patients and three medical experts for lunch on Sunday, May 4 from 12:30 to 3:30 pm in a private dining room at Dorrian's restaurant in Manhattan (1616 2nd Avenue, corner of 84th Street). (carcinoid.org)
Underlying carcinoid syndrome1
  • Treatment focuses on control of the underlying carcinoid syndrome, targeting subsequent valvular heart disease and managing consequent heart failure. (karger.com)
Metastatic1
  • Characterization, Prognosis, and Treatment of Patients With Metastatic Lung Carcinoid Tumors. (nih.gov)
Secreted by carcinoid tumors1
  • If a patient is thought to have carcinoid syndrome, blood and urine tests must be performed to determine levels of bioactive substances secreted by carcinoid tumors. (medscape.com)
Management of patients with carcinoid2
  • Advances in the management of patients with carcinoid syndrome. (harvard.edu)
  • The optimal management of patients with carcinoid tumors involves a multidisciplinary team of health care providers including an oncologist, gastroenterologist, surgeon, radiologist and nuclear medicine specialist. (medifocus.com)
Valvular heart d3
  • On July 8, 1997, 24 cases of valvular heart disease in women who had been treated with fenfluramine and phentermine were publicly reported (1). (cdc.gov)
  • Right-sided valvular heart disease may develop after several years. (msdmanuals.com)
  • Ergotamine has been associated with numerous vascular complications but only rarely with fibrosing disorders or valvular heart disease. (nih.gov)
Symptoms23
  • This response favorably altered the clinical course of the patient, enabling corrective valvular surgery, enhancing health-related quality of life, improving symptoms (from New York Heart Association grade III at baseline to grade I after 6 cycles), stabilizing the disease, and substantially reducing the level of 5-hydroxyindole acetic acid. (snmjournals.org)
  • A condition where some NETs produce increased levels of the hormone serotonin and cause a number of symptoms such as flushing (redness) of the face, diarrhoea (loose bowel motions), asthma or wheezing, heart failure, stomach cramps, swelling of the ankles, fast heart rate. (christie.nhs.uk)
  • Carcinoid syndrome is a paraneoplastic syndrome comprising the signs and symptoms that occur secondary to neuroendocrine tumors (formerly known as carcinoid tumors). (wikipedia.org)
  • The syndrome is caused by neuroendocrine tumors most often found in the gut releasing biologically active substances into the blood causing symptoms such as flushing and diarrhea, and less frequently, heart failure, vomiting and bronchoconstriction. (wikipedia.org)
  • The biologically active substances that are released by the tumors cause the symptoms of the carcinoid syndrome. (wikipedia.org)
  • These substances act on the vessels to produce the symptoms of the carcinoid syndrome. (wikipedia.org)
  • The symptoms of the carcinoid syndrome result from the action of these substances largely on the blood vessels. (wikipedia.org)
  • In the pulmonary neuroendocrine tumors or metastases, histamine release and kallikrein metabolism are the vasoactive mediators of flushing and the other symptoms of carcinoid syndrome. (wikipedia.org)
  • Symptoms of carcinoid crisis include flushing, hypotension, arrhythmia and bronchospasm. (wikipedia.org)
  • Assessment of change in quality of life, carcinoid syndrome symptoms and healthcare resource utilization in patients with carcinoid syndrome. (harvard.edu)
  • Impact of carcinoid syndrome symptoms and long-term use of somatostatin analogs on quality of life in patients with carcinoid syndrome: A survey study. (harvard.edu)
  • Cost reduction from resolution/improvement of carcinoid syndrome symptoms following treatment with above-standard dose of octreotide LAR. (harvard.edu)
  • Carcinoid tumors are slow-growing tumors and most do not cause symptoms until they interfere with daily function or metastasize. (medifocus.com)
  • Carcinoid syndrome describes a combination of symptoms that result from hormones or hormone-like substances, (e.g., serotonin, gastrin, ACTH) that are produced by some carcinoid tumors. (medifocus.com)
  • Carcinoid crisis - when all of the above symptoms occur at the same time. (medifocus.com)
  • Because symptoms frequently occur relatively late during the course of valvular incompetence, the prevalence of valve lesions was assessed for patients who were exposed to these drugs but who had no obvious history of cardiac disease or cardiac symptoms. (cdc.gov)
  • Although there are different ways for an extremely rare disease to develop, it's common that they have no treatment, and people have to manage the symptoms as best they can. (bewellbuzz.com)
  • Treating underlying cancer can reduce symptoms, but it can develop into carcinoid heart disease, which thickens heart valves and creates leaks that can be fatal. (bewellbuzz.com)
  • Endocrinologically active tumors of the diffuse peripheral endocrine or paracrine system (neuroendocrine tumors) produce various amines and polypeptides with corresponding symptoms and signs, including carcinoid syndrome. (msdmanuals.com)
  • Metabolic products released by primary pulmonary and ovarian carcinoids bypass the portal route and may similarly induce symptoms. (msdmanuals.com)
  • Rare intestinal carcinoids with only intra-abdominal spread can drain directly into the systemic circulation or the lymphatics and cause symptoms. (msdmanuals.com)
  • Carcinoid tumors grow slowly, and symptoms may not occur for several years, if at all. (medscape.com)
  • May be asymptomatic or symptoms of primary disease. (easymbbs.com)
Cardiac8
  • The opinion of a cardiothoracic surgeon was sought, who deemed the disease inoperable because of suboptimal cardiac function. (snmjournals.org)
  • Heart Disease: About 60-70% of the those affected by carcinoid syndrome develop cardiac complications. (wikipedia.org)
  • The Central Minnesota Heart Center at St. Cloud Hospital also known as MN Heart is a comprehensive cardiac care center dedicated to the discovery, management and control of cardiac disease in the adult population. (mnheart.com)
  • Cardiac manifestations constitute CARCINOID HEART DISEASE. (harvard.edu)
  • During chest examination, a pulmonary systolic and diastolic heart murmur may be heard if cardiac involvement is present. (medscape.com)
  • Thickening of the endocardium of the cardiac chambers and papillary muscles and thickening and deformation of the valve cusps and chordae tendineae can lead to heart failure, influencing valvular function and causing regurgitation, stenosis, or combined functional lesions. (medscape.com)
  • They were compared to a historical group of non-COVID patients with undifferentiated dyspnea also without known cardiac or pulmonary disease. (bvsalud.org)
  • While SLE, systemic sclerosis (scleroderma), and mixed connective tissue disease may cause myocarditis, these more commonly involve the pericardium, coronary arteries, or cardiac valves. (mhmedical.com)
Neuroendocrine cells2
  • Carcinoid tumors arise from neuroendocrine cells, which are widespread in the human body, especially in the organs derived from the primitive intestine (see the image below). (medscape.com)
  • Overview of Carcinoid Tumors Carcinoid tumors develop from neuroendocrine cells in the gastrointestinal tract (90%), pancreas, pulmonary bronchi, and rarely the genitourinary tract. (msdmanuals.com)
Serotonin9
  • Left heart valves are usually spared because vasoactive substances such as serotonin are enzymatically inactivated in the lung vasculature. (karger.com)
  • Bochemical diagnosis of carcinoid tumors is based on the measurement of the serotonin metabolite 5-HIAA in urine. (medscape.com)
  • If high levels of the hormone serotonin are produced over a long time, this can cause thickening of the heart valves and can lead to failure of the heart. (christie.nhs.uk)
  • Increased amounts of serotonin lead to increased gut motility causing the diarrhea seen in carcinoid syndrome. (wikipedia.org)
  • Increased amounts of serotonin can also cause the flushing seen as the main symptom of carcinoid syndrome. (wikipedia.org)
  • The histopathologic features were similar to those observed in carcinoid-induced valvular disease, a serotonin-related syndrome. (cdc.gov)
  • Serotonin , the primary hormone produced by carcinoid tumors, acts on smooth muscle to cause diarrhea, colic, and malabsorption. (msdmanuals.com)
  • The name was chosen to separate these tumors from ordinary malignancies (carcinomas), but by the 1950s, the fact that carcinoids could be malignant was obvious, thanks to Erspamer and Asero (1952), who identified serotonin production by carcinoid tumors. (medscape.com)
  • Right heart problems may develop because the tricuspid valve is stenosed by serotonin action, causing shortness of breath after a few years. (medscape.com)
Intestinal carcinoid1
  • A section (on the right) of an intestinal carcinoid mass arising from the mucosa (150 X). Image courtesy of Professor Pantaleo Bufo, University of Foggia, Italy. (medscape.com)
Mitral3
  • The course will cover the following topics: Mitral and tricuspid valves, arrhythmia, endocarditis, hypertrophic obstructive cardiomyopathy, carcinoid and aortic root. (eacts.org)
  • Mitral and aortic valve disease associated with ergotamine therapy for migraine. (nih.gov)
  • The surgically excised mitral and aortic valves were involved by a proliferative process that was strikingly similar to lesions described in patients with carcinoid heart disease and methysergide-associated valvular disease. (nih.gov)
Tumors originate2
  • Typically, 90% of carcinoid tumors originate from the distal ileum or appendix (the embryologic midgut. (medscape.com)
  • Hindgut Carcinoid Tumors - These tumors originate in the large intestines, specifically in the transverse colon, descending colon, and rectum. (medifocus.com)
Tricuspid valve replacement2
Patients11
  • Considering the significantly shortened overall survival of patients with carcinoid heart disease, the relative paucity of available treatment options, and the risk of complications during corrective surgery on poorly controlled functioning disease, 177 Lu-DOTATATE can emerge as a potent option in this group of patients. (snmjournals.org)
  • Carcinoid heart disease manifests in many patients with carcinoid syndrome ( 2 ), but the prevalence dropped to approximately 20% after the introduction of newer therapies such as somatostatin analogs and 177 Lu-DOTATATE, along with everolimus, sunitinib, and the combination of capecitabine and temozolomide ( 3 ). (snmjournals.org)
  • Carcinoid heart diseases affect in more than half percent of the patients with the carcinoid tumors, got from the midgut neuroendocrine tissue. (mnheart.com)
  • Retrospective review of serotonergic medication tolerability in patients with neuroendocrine tumors with biochemically proven carcinoid syndrome. (harvard.edu)
  • A study found that levels of chromogranin-A (CgA) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were associated with the presence and severity of tricuspid regurgitation as a manifestation of carcinoid heart disease among patients with neuroendocrine tumors. (acc.org)
  • 2 Characteristic echocardiographic features of advanced carcinoid heart disease include thickening and retraction of immobile tricuspid valve leaflets with associated tricuspid regurgitation, which is severe in 90 percent of patients. (acc.org)
  • Patients are generally asymptomatic at rest during the early stage of the disease. (medscape.com)
  • This phase III trial studies cabozantinib to see how well it works compared with placebo in treating patients with neuroendocrine or carcinoid tumors that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced). (stanford.edu)
  • Subjects included consecutive long COVID patients without prior history of heart or lung disease sent from the Post-COVID Care Clinic for CPET. (bvsalud.org)
  • Emergency TAVI for acute heart failure due to severe aortic stenosis in critically ill patients with or without cardiogenic shock [published online ahead of print, 2022 Oct 10]. (herzklappenzentrum.org)
  • Clinical Outcome Following Transcatheter Aortic Valve Implantation in Patients With Chronic Obstructive Pulmonary Disease. (herzklappenzentrum.org)
Syndromes2
  • Carcinoid tumors and related syndromes may be a part of multiple endocrine neoplasia . (medscape.com)
  • The heart may be involved in a number of systemic syndromes. (mhmedical.com)
Surgical2
Etiology2
  • 1] The heart is grossly normal, although histologic abnormalities are often present, depending on the etiology of the restrictive cardiomyopathy. (medscape.com)
  • However, these may be considered separate diseases because the etiology is known. (medscape.com)
Asymptomatic2
  • Particularly noteworthy was a remarkable improvement in the symptomatic scale, with the patient being asymptomatic for dyspnea at that point (from New York Heart Association grade III at baseline to grade I after 6 cycles) and with a substantial reduction of urinary 5-hydroxyindole acetic acid (5-HIAA) to nearly one sixth the baseline level. (snmjournals.org)
  • It is probable that more people may actually have carcinoid tumors but because carcinoids are often asymptomatic, an individual may never know that a carcinoid has developed. (medifocus.com)
Diagnosis2
  • The diagnosis of pituitary disease is generally uncomplicated. (bmj.com)
  • With the diagnosis of cancer or heart disease comes the reality of medical bills, time off for treatments, monies for living expenses, and for some, the cost of high deductibles. (mutualofomaha.com)
Metastases2
  • and asthma attacks-caused by vasoactive hormones secreted by metastases from carcinoid tumors. (medscape.com)
  • Neuroendocrine tumors arising in the bronchi may be associated with manifestations of carcinoid syndrome without liver metastases because their biologically active products reach the systemic circulation before passing through the liver and being metabolized. (wikipedia.org)
20221
Liver3
  • Carcinoids do not produce the malignant carcinoid syndrome until they are no longer confined to the small bowel or mesentery, perhaps because the liver breaks down the secretory products of tumors restricted to those locations. (medscape.com)
  • The carcinoid tumors are usually located in the gastrointestinal tract and metastasize to the liver. (harvard.edu)
  • 2006-2012 he was the clinical lead for "NHS Evidence" for Gastroenterology and Liver diseases (under the auspices of NICE), chairing annual evidence updates into gastrointestinal and liver disorders. (cor2ed.com)
Acute4
  • She was subsequently admitted for acute decompensated heart failure. (acc.org)
  • In some cases, carcinoid tumors present as acute appendicitis or chronic pain in the lower right abdominal quadrant. (medscape.com)
  • Chemotherapies, radiation therapy, and targeted therapies can produce acute side effects or lasting adverse consequences on the heart and circulatory system, making the field of cardio-oncology increasingly important in effective patient care. (physioshop.co.uk)
  • Eur Heart J Acute Cardiovasc Care. (herzklappenzentrum.org)
Flushing4
  • At the time of his referral for consideration of PRRT, he presented with severe flushing, diarrhea, and dyspnea of grade III on the New York Heart Association scale, uncontrolled by monthly long-acting octreotide injection. (snmjournals.org)
  • Bronchoconstriction: A relatively rare symptom affects about 15% of those having carcinoid syndrome and often accompanies flushing, sneezing, and shortness of breath. (wikipedia.org)
  • [ 20 ] Flushing is the most frequent symptom and may be brief (eg, 2-5 min) or may last for several hours, usually in later disease stages. (medscape.com)
  • Malignant carcinoid syndrome is not a cause of sustained hypertension , and a rise in blood pressure during flushing is rare. (medscape.com)
Occurs4
  • The carcinoid syndrome occurs in approximately 10% of all neuroendocrine tumors or about 30-40% of more advanced/well developed neuroendocrine tumors. (wikipedia.org)
  • The carcinoid syndrome occurs secondary to neuroendocrine tumors. (wikipedia.org)
  • Gigantism is an extremely rare disease that occurs when there's too much growth hormone before the bone plates have fused. (bewellbuzz.com)
  • Carcinoid heart disease occurs primarily on the right side of the heart but may involve the left side to a minimal degree. (medscape.com)
Cardiovascular1
  • Cardio-Oncology Practice Manual is a comprehensive, portable guide that provides practical approaches to assessment and management of cardiovascular diseases due to the effects of cardiotoxic agents and treatments. (physioshop.co.uk)
Severe2
Gastrointestinal tract1
  • About 66% of all carcinoid tumors develop in the gastrointestinal tract. (medifocus.com)
Secondary2
  • Generalised hyperhidrosis may be primary and idiopathic or secondary to systemic disease. (racgp.org.au)
  • Generalised hyperhidrosis affects the entire body and may be idiopathic or secondary to an underlying metabolic disorder or systemic disease. (racgp.org.au)
Clinical3
  • Most carcinoid tumors are now known to be slow growing malignant tumors that have their own specific biological and clinical characteristics. (medifocus.com)
  • Many clinical studies suggest that an increase in EAT volume is associated with coronary artery disease. (go.jp)
  • and Dr. Jerome S. Zacks , cardiologist, Assistant Clinical Professor of Medicine at The Mt. Sinai Medical Center and founder of the Carcinoid Heart Center in New York City. (carcinoid.org)
Substances1
  • There are over 40 substances known to be secreted by these tumors but the exact effect of each and their contribution to the carcinoid syndrome is unknown. (wikipedia.org)
Prevalence1
  • However, hereditary diseases may have regional characteristics, and few data are available regarding the prevalence of FH throughout particular regions in Japan. (go.jp)
Systemic2
  • The most common type of myocardial involvement is an infiltrative cardiomyopathy, such as systemic amyloidosis, sarcoidosis, hemochromatosis, Fabry disease, or glycogen storage disease. (mhmedical.com)
  • SLE may present with pericarditis, and pericardial involvement is not uncommon (but is less frequently symptomatic) in active rheumatoid arthritis, systemic sclerosis, and mixed connective tissue disease. (mhmedical.com)
Congenital Heart D1
  • Predictors of Human Milk Feeding and Direct Breastfeeding for Infants with Single Ventricle Congenital Heart Disease: Machine Learning Analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry. (cdc.gov)
Lung1
  • Approximately 3,000 new cases of lung carcinoid tumors are diagnosed in the United States each year. (medifocus.com)
20231
Syndrome develops1
  • Carcinoid syndrome develops in about 50% of the population with neuroendocrine tumors ( 1 ). (snmjournals.org)
Lesions1
  • Although valvular lesions were observed on both sides of the heart, a left-sided valve was affected in all cases. (cdc.gov)
Valve Disease1