Carcinoid heart disease: typical fi ndings on echocardiography and cardiac magnetic resonance

Summary Carcinoid syndrome is often complicated by carcinoid heart disease. Deposition of carcinoid plaques on the endocardium of the tricuspid and pulmonary valves causes the typical echocardiographic iconography with thickening of the leafl ets and valvular insuffi ciency and/or stenosis leading to right heart failure. Additionally, the fi brous plaques can be visualized with cardiac magnetic resonance using delayed enhancement sequences. Accurate assessment of the dimensions of the dilated right ventricle by magnetic resonance implicates therapeutic options and defi nes prognosis. We report the case of a patient with advanced right heart failure as the clue to the diagnosis of carcinoid syndrome. Echocardiography was suggestive. Advanced investigation with magnetic resonance confi rmed carcinoid plaque deposition on the tricuspid and the pulmonary valves, and we also had evidence of plaque deposition in the right ventricle. Multimodality imaging is essential in the investigation of this rare disorder.