When right heart valves are open 24/7

Abstract

A 76-year-old man presented with fatigue, facial flushing,and weight loss experienced over a period of 4 months. An examination revealed a palpable abdominal mass, elevated jugular venous pressure, and a pansystolic heart murmur at the lower left sternal edge. A computed tomography scan wassuggestive of a carcinoid tumor of the small bowel withmesenteric involvement and liver metastases. The levelof urinary 5-hydroxyindole acetic acid was significantlyelevated and a magnetic resonance image of the liver showed extensive metastases. A transthoracic echocardiogram showed thetypical findings of carcinoid heart disease.