Hôpital Bichat/Beaujon, Service de cardiologie, 46, rue Henri Huchard, 75018 Paris
Hospices Civils de Lyon, Service d’oncologie digestive, 5, place d’Arsonval, 69003 Lyon
Hôpital Beaujon, Service de gastroentérologie-pancréatologie, 100 boulevard du Général Leclerc, 92110 Clichy
Hospices Civils de Lyon, Service de cardiologie, 5, place d’Arsonval, 69003 Lyon
Carcinoid heart disease (CHD) occurs in 30% to 50% of patients with metastatic small-intestine neuroendocrine tumors associated with carcinoid syndrome. It is responsible for a significant increase in morbidity and mortality. Its pathophysiology is still poorly understood, but serotonin seems to play a major role in the formation of endocardial fibrous plaques, mainly in the right heart. These lesions are responsible for valve regurgitations or stenosis, mainly tricuspid and pulmonary, frequently progressing to right heart failure. Cardiac ultrasound is the key examination for the screening and diagnosis of CHD, guided by the clinic and biomarker assays (5HIAA, BNP). The treatment of CHD is complex and requires multidisciplinary collaboration between gastroenterologists, cardiologists, anesthesiologists and cardiac surgeons. In the event of severe valve damage, cardiac surgery is the standard treatment, but its timing is a real challenge.