Hollowed John, Woo Hawkin, Hamburg Solomon, Ardehali Abbas
Division of Cardiology, University of California, Los Angeles, Los Angeles, California.
Department of Medicine, University of California, Los Angeles, Los Angeles, California.
Tex Heart Inst J. 2025 Jul 9;52(2):e258599. doi: 10.14503/THIJ-25-8599. eCollection 2025 Jul-Dec.
A 63-year-old man with a history of hypertension, prediabetes, and sleep apnea presented with pedal edema, weight loss, and flushing. Laboratory work revealed elevated B-type natriuretic peptide and normocytic anemia. Echocardiography showed right ventricular enlargement, severe tricuspid valve regurgitation, and thickened tricuspid valve leaflets, raising suspicion for carcinoid heart disease. Further testing confirmed a neuroendocrine tumor with liver metastasis. Despite somatostatin therapy, the patient's symptoms were refractory to diuretics. Surgical intervention with tricuspid and pulmonary valve replacement was undertaken. Postoperatively, the patient demonstrated substantial improvement in functional tolerance and quality of life. This case highlights the importance of surgical intervention in advanced carcinoid heart disease.
一名63岁男性，有高血压、糖尿病前期和睡眠呼吸暂停病史，出现足部水肿、体重减轻和面部潮红。实验室检查显示B型利钠肽升高和正细胞性贫血。超声心动图显示右心室扩大、严重三尖瓣反流和三尖瓣叶增厚，怀疑为类癌性心脏病。进一步检查证实为伴有肝转移的神经内分泌肿瘤。尽管进行了生长抑素治疗，但患者的症状对利尿剂治疗无效。进行了三尖瓣和肺动脉瓣置换的手术干预。术后，患者的功能耐受性和生活质量有了显著改善。该病例突出了手术干预在晚期类癌性心脏病中的重要性。
