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अमूर्त

Carcinoid Heart Disease: Treatment Challenges

Mustafa Bdiwi*

Carcinoid Heart Disease (CHD) or Hedinger syndrome is a serious complication of carcinoid syndrome or what is called Neuroendocrine Tumor (NET), it may occur in up to 60% of patients with carcinoid syndrome or can be the initial presentation in up to 20% and it is associated with poor survival. It usually affects the right side of the heart, especially, the tricuspid and pulmonic valves, and leads to valvular regurgitation and lesser extent stenosis due to inflammation and plaque deposits caused by the circulating serotonin and other vasoactive peptides secreted by NET. Small intestine and lung are the two most common sites of NET and small intestine is the commonest primary site. CHD treatment is challenging and it could be either medical early in the course of the disease but may need surgical intervention with valve replacement in the advanced disease with right heart failure.