[Three-dimensional echocardiography in carcinoid heart disease].

A 67-year-old man had presented 7 months earlier with complaints of flushing, diarrhea and tiredness. Etiologic investigation diagnosedmetastaticmidgut neuroendocrine carcinoid tumor for which he had trans-arterial embolization and started monthly sandostatin. In follow-up, he developed progressive exertional dyspnea and was referred for carcinoid heart screen. On physical examination there were systolic and early diastolic right-sided murmurs, increased jugular venous pressure with prominent v wave and pitting peripheral edema. Bidimensional transthoracic echocardiography showed hypomobile fibrotic tricuspid leaflets that resulted in incomplete coaptation and severe regurgitation. The pulmonary valve was not clearly visualized but there was evidence of moderate regurgitation and mild stenosis. Three-dimensional (3D) echocardiography using volume-rendered imaging provided global simultaneous assessment of the three tricuspid leaflets, which were thickened,