RESUMO
Carcinoid heart disease is a rare disease, and its prevalence is uncertain. The aim of the present prospective study was to assess the prevalence of carcinoid heart disease using annual echocardiographic follow-up. We studied 80 consecutive patients presenting with histologically proven digestive endocrine tumor and carcinoid syndrome. All patients underwent annual conventional transthoracic echocardiographic studies and measurement of biologic carcinoid markers. Right- and left-sided carcinoid heart disease and the score of the severity of carcinoid heart disease were systematically assessed. At baseline, the prevalence of right- and left-sided carcinoid heart disease was 33% and 8%, respectively. At the end of follow-up, the corresponding prevalence was 53% and 21%. The correlations were strong between urinary 5-hydroxyindoleacetic acid (5-HIAA) and the right-sided carcinoid heart disease score (r = 0.75, p <0.0001), between urinary 5-HIAA and the left-sided carcinoid heart disease score (r = 0.83, p = 0.001), and between urinary 5-HIAA and the overall carcinoid heart disease score (r = 0.84, p <0.0001). All patients with > or =3 years of carcinoid syndrome and increased level of urinary 5-HIAA presented with echocardiographic evidence of valve disease on routine monitoring. In conclusion, the prevalence of carcinoid heart disease remained high and increased during follow-up. Carcinoid heart disease progresses over time, highlighting the need for echocardiographic follow-up once carcinoid syndrome has been diagnosed.
Assuntos
Doença Cardíaca Carcinoide/diagnóstico por imagem , Doença Cardíaca Carcinoide/urina , Ecocardiografia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/urina , Ácido Hidroxi-Indolacético/urina , Idoso , Biomarcadores/urina , Doença Cardíaca Carcinoide/epidemiologia , Doença Cardíaca Carcinoide/cirurgia , Feminino , Seguimentos , Neoplasias Cardíacas/epidemiologia , Neoplasias Cardíacas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Paris/epidemiologia , Prevalência , Estudos Prospectivos , Índice de Gravidade de DoençaRESUMO
Cardiac paragangliomas are among the rarest primary cardiac tumors. We present a case of left atrial paraganglioma in a patient who presented with symptoms and signs of catecholamine excess in which cardiovascular magnetic resonance in multiple orientations and PET-CT played an important role in the diagnosis and tissue characterization.
Assuntos
Neoplasias Cardíacas/diagnóstico , Imagem Cinética por Ressonância Magnética , Paraganglioma Extrassuprarrenal/diagnóstico , Tomografia por Emissão de Pósitrons , Complicações Neoplásicas na Gravidez/diagnóstico , Tomografia Computadorizada por Raios X , Adulto , Biomarcadores/urina , Procedimentos Cirúrgicos Cardíacos , Catecolaminas/urina , Feminino , Átrios do Coração/patologia , Neoplasias Cardíacas/cirurgia , Neoplasias Cardíacas/urina , Humanos , Paraganglioma Extrassuprarrenal/cirurgia , Paraganglioma Extrassuprarrenal/urina , Valor Preditivo dos Testes , Gravidez , Complicações Neoplásicas na Gravidez/cirurgia , Complicações Neoplásicas na Gravidez/urina , Terceiro Trimestre da Gravidez , Resultado do TratamentoAssuntos
Dispneia/etiologia , Febre/etiologia , Neoplasias Cardíacas/diagnóstico , Melanoma/diagnóstico , Dermatopatias/etiologia , Idoso , Cloretos , Evolução Fatal , Feminino , Compostos Férricos , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/urina , Humanos , Melanoma/complicações , Melanoma/urinaRESUMO
A case of right atrial myxoma presenting with right heart failure and proteinuria is described. Proteinuria was variable and this corresponded with the degree of systemic venous congestion. On one occasion the proteinuria was within the nephrotic range. There was no evidence of intrinsic renal pathology. The right heart failure and proteinuria resolved after tumour removal, suggesting that the etiology of urinary protein loss was a reversible increase in glomerular permeability.
Assuntos
Insuficiência Cardíaca/urina , Neoplasias Cardíacas/urina , Mixoma/urina , Nefrose/etiologia , Proteinúria/etiologia , Idoso , Função do Átrio Direito , Ecocardiografia , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/fisiopatologia , Insuficiência Cardíaca/complicações , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem , Humanos , Mixoma/complicações , Mixoma/diagnóstico por imagem , Nefrose/urinaRESUMO
Cardiac pheochromocytomas are rare. Thirty cases have been reported in the literature. We report the cases of 2 more patients in whom the diagnosis was established using coronary angiography and who underwent surgical resection using cardiopulmonary bypass. We also review the literature on the subject.