Left heart involvement with cardiac shunt complicating carcinoid heart disease.

The manifestations of carcinoid heart disease are usually right heart failure due to pulmonary and tricuspid valve disease and sometimes high output failure due to peripheral vasodilation. Recently there has been one case report of progressive central cyanosis due to right to left shunting through a patent foramen ovale. We present a similar case where such a shunt developed and was also complicated by significant valvular disease affecting the left side of the heart.