Off Topic and ‘Over the Fence’ Banter

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Carcinoid Heart Disease – Definition and Treatment

The prognosis of carcinoid heart disease depends on the location of the tumour. The tumour can occur in the lungs, heart, or both. In the United States, the majority of patients with the disease develop pulmonary fibrosis. However, the tumor can occur anywhere in the body. In patients with this condition, the tumor can be asymptomatic or present in small numbers. There are many causes of this condition.

The progression of carcinoid heart disease is based on the rate of tricuspid regurgitation, thickening of the tricuspid leaflets, and immobility of the tricuspid valve. The rate of disease progression is unknown as there were few deaths in this study. Generally, the rate of progression is between 10 and 30 percent. The rates of progression in other studies are consistent with these estimates.

As of 2017, there are no international consensus guidelines on the diagnosis and management of carcinoid heart disease. Various studies, including those from the Journal of Neuroendocrinology, have shown that the severity of tricuspid valve regurgitation may be a good predictor of outcome. According to Moller JE, a study of 17 carcinoid heart disease series found that the 30-day mortality rate for carcinoid heart disease was 20%.

The biochemical and hormonal burden of carcinoid heart disease determine its progression. Several treatments may improve symptoms such as edema and ascites. Although diuretics can be effective, they do not address the primary underlying cause of carcinoid heart disease. Before undergoing valve surgery, patients with this condition must first optimize medical management. Somatostatin analogues, however, may provide additional benefits by reducing the secretion of vasoactive substances.

The multidisciplinary treatment of carcinoid heart disease requires a team approach by cardiac surgeons, NET specialists, anesthesiologists, and hepatic artery ligation. The resulting CT scan is a good way to diagnose carcinoid heart disease. It is important to note that the morphological and hemodynamic changes of the heart can be seen during echocardiography, which makes it an important tool in the management of this condition.

Symptoms of carcinoid heart disease are related to the hormonal and biochemical burden of the disease. Often, the patient with this condition will have symptoms that are worsened by pulmonary stenosis and severe tricuspid regurgitation. In addition to these symptoms, the doctor may also prescribe somatostatin analogues to help with the symptoms of the condition. In some cases, these medications may be helpful for patients suffering from the symptoms of carcinoid heart disease.

Patients with carcinoid heart disease usually experience tricuspid valve regurgitation, which is the most common form of the condition. They are also often asymptomatic until their condition progresses to the point that the patient no longer has any functional ability to breathe. Eventually, patients with the disease may suffer from progressive heart failure. This condition often requires immediate intervention. The best way to diagnose carcinoid heart disease is through a complete cardiology evaluation.

 

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