Heart 1998;80:623-626 ( December )
Case report
Carcinoid heart disease from ovarian primary presenting with
acute pericarditis and biventricular failure
Division of Cardiology, San Paolo Hospital, University
of Milan, Milan, Italy
Correspondence to: Dr D Vergani, v. Anguissola 31, 20146 Milano, Italy.
Accepted for publication 8 June 1998
A case is described of a 54 year old woman who had acute
pericarditis with large exudative effusion accompanied by severe right
and left ventricular failure. The patient was finally diagnosed with
carcinoid heart disease from an ovarian carcinoid teratoma. She was
treated with octreotide
a somatostatin analoguefollowed by radical
surgical resection of the neoplasm. At one year follow up only mild
carcinoid tricuspid regurgitation remained. Only 16 cases of carcinoid
heart disease from an ovarian primary have been described in
literature. Moreover clinically manifest acute, non-metastatic
pericarditis and left heart failure are not considered as possible
presentations of carcinoid heart disease, whatever the origin. In a
recent series a small pericardial effusion was considered an infrequent
and unexpected echocardiographic finding in carcinoid heart patients.
One case of "carcinoid pericarditis" has previously been described
as a consequence of pericardial metastasis. Left sided heart
involvement is usually caused by bronchial carcinoids or patency of
foramen ovale; both were excluded in the case presented.
© 1998 by Heart
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