Carcinoid syndrome echocardiography or ultrasound: Difference between revisions
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{{CMG}}{{AE}}{{PSD}} | {{CMG}}{{AE}}{{PSD}} | ||
==Overview== | ==Overview== | ||
Trans-thoracic [[echocardiography]] findings include thickening and retraction of immobile [[Tricuspid valves|tricuspid valve]] leaflets with associated [[tricuspid regurgitation]] and immobility of the [[pulmonary valve]] [[Cusps of heart valves|cusps]]. Trans-esophageal [[Echocardiograms|echocardiography]] findings provide incremental assessment of the degree of [[cardiac valve]] involvement and the [[Atrial septum|atrial septal]] [[anatomy]] in patients with [[Carcinoid Disease|carcinoid]] [[Heart diseases|heart disease]]. | |||
==Echocardiography== | ==Echocardiography== | ||
=Transthoracic echocardiography= | |||
*It is the [[Gold standard (test)|gold standard]] for diagnosis and follow-up of [[Carcinoid Disease|carcinoid]] [[Heart diseases|heart disease.]]<ref name="pmid7681733">{{cite journal |vauthors=Pellikka PA, Tajik AJ, Khandheria BK, Seward JB, Callahan JA, Pitot HC, Kvols LK |title=Carcinoid heart disease. Clinical and echocardiographic spectrum in 74 patients |journal=Circulation |volume=87 |issue=4 |pages=1188–96 |date=April 1993 |pmid=7681733 |doi= |url=}}</ref><ref name="StougiannosMichas2017">{{cite journal|last1=Stougiannos|first1=Pavlos|last2=Michas|first2=George|last3=Evdoridis|first3=Constantinos|last4=Arapantoni-Dadioti|first4=Petroula|last5=Tolios|first5=Panagiotis|last6=Kaplanis|first6=Ioannis|last7=Trikas|first7=Athanasios|title=Carcinoid heart disease in an elderly female patient: the value of transthoracic echocardiography|journal=Hellenic Journal of Cardiology|volume=58|issue=1|year=2017|pages=65–68|issn=11099666|doi=10.1016/j.hjc.2017.01.018}}</ref> | |||
*Should be performed in all patients with [[carcinoid syndrome]] and high suspicion of [[Carcinoid Disease|carcinoid]] [[Heart diseases|heart disease]] such as clinical features or raised [[NT-proBNP]] and/or [[5-HIAA]] levels. | |||
*Findings includes followings: | |||
#Thickening and retraction of immobile [[Tricuspid valves|tricuspid valve]] leaflets with associated [[tricuspid regurgitation]], which is severe at the time of identification in 90 percent of [[patients]]. | |||
#Immobility of the [[pulmonary valve]] [[Cusps of heart valves|cusps]]. | |||
=Transesophageal echocardiography= | |||
*[[TEE]] is primarily used intraoperatively to image the patient with [[carcinoid]] [[Heart diseases|heart disease]] during [[valve replacement surgery]].<ref name="BanzaliTiwari2007">{{cite journal|last1=Banzali|first1=Franklin M.|last2=Tiwari|first2=Anil K.|last3=Frantz|first3=Robert|last4=D’Attellis|first4=Nicola|title=Valvular Heart Disease Caused by Carcinoid Syndrome: Emphasis on the Use of Intraoperative Transesophageal Echocardiography|journal=Journal of Cardiothoracic and Vascular Anesthesia|volume=21|issue=6|year=2007|pages=855–857|issn=10530770|doi=10.1053/j.jvca.2007.06.014}}</ref> | |||
*[[TEE]] may provide incremental assessment of the degree of [[cardiac valve]] involvement and the [[Atrial septum|atrial septal]] anatomy in [[patients]] with [[carcinoid]] [[Heart diseases|heart disease.]] | |||
=Cardiac magnetic resonance= | |||
*It can be used to evaluate the [[pulmonary valve]], identify [[cardiac]] [[metastases]], and assess [[right ventricular]] size and function.<ref name="pmid16272847">{{cite journal |vauthors=Bastarrika G, Cao MG, Cano D, Barba J, de Buruaga JD |title=Magnetic resonance imaging diagnosis of carcinoid heart disease |journal=J Comput Assist Tomogr |volume=29 |issue=6 |pages=756–9 |date=2005 |pmid=16272847 |doi= |url=}}</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
Trans-thoracic echocardiography findings include thickening and retraction of immobile tricuspid valve leaflets with associated tricuspid regurgitation and immobility of the pulmonary valve cusps. Trans-esophageal echocardiography findings provide incremental assessment of the degree of cardiac valve involvement and the atrial septal anatomy in patients with carcinoid heart disease.
Echocardiography
Transthoracic echocardiography
- It is the gold standard for diagnosis and follow-up of carcinoid heart disease.[1][2]
- Should be performed in all patients with carcinoid syndrome and high suspicion of carcinoid heart disease such as clinical features or raised NT-proBNP and/or 5-HIAA levels.
- Findings includes followings:
- Thickening and retraction of immobile tricuspid valve leaflets with associated tricuspid regurgitation, which is severe at the time of identification in 90 percent of patients.
- Immobility of the pulmonary valve cusps.
Transesophageal echocardiography
- TEE is primarily used intraoperatively to image the patient with carcinoid heart disease during valve replacement surgery.[3]
- TEE may provide incremental assessment of the degree of cardiac valve involvement and the atrial septal anatomy in patients with carcinoid heart disease.
Cardiac magnetic resonance
- It can be used to evaluate the pulmonary valve, identify cardiac metastases, and assess right ventricular size and function.[4]
References
- ↑ Pellikka PA, Tajik AJ, Khandheria BK, Seward JB, Callahan JA, Pitot HC, Kvols LK (April 1993). "Carcinoid heart disease. Clinical and echocardiographic spectrum in 74 patients". Circulation. 87 (4): 1188–96. PMID 7681733.
- ↑ Stougiannos, Pavlos; Michas, George; Evdoridis, Constantinos; Arapantoni-Dadioti, Petroula; Tolios, Panagiotis; Kaplanis, Ioannis; Trikas, Athanasios (2017). "Carcinoid heart disease in an elderly female patient: the value of transthoracic echocardiography". Hellenic Journal of Cardiology. 58 (1): 65–68. doi:10.1016/j.hjc.2017.01.018. ISSN 1109-9666.
- ↑ Banzali, Franklin M.; Tiwari, Anil K.; Frantz, Robert; D’Attellis, Nicola (2007). "Valvular Heart Disease Caused by Carcinoid Syndrome: Emphasis on the Use of Intraoperative Transesophageal Echocardiography". Journal of Cardiothoracic and Vascular Anesthesia. 21 (6): 855–857. doi:10.1053/j.jvca.2007.06.014. ISSN 1053-0770.
- ↑ Bastarrika G, Cao MG, Cano D, Barba J, de Buruaga JD (2005). "Magnetic resonance imaging diagnosis of carcinoid heart disease". J Comput Assist Tomogr. 29 (6): 756–9. PMID 16272847.