Citation Information :
Choudhury M, Malhotra R. Hedinger Syndrome Secondary to Carcinoid Tumor of the Ovary: Anesthetic Challenge and Echocardiographic Illustration. J Perioper Echocardiogr 2020; 8 (2):43-47.
Carcinoid syndrome is the conglomeration of symptoms mediated by humoral factors produced by a neuroendocrine tumor. It is characterized by gastrointestinal hypermotility, bronchospasm, hypotension, and vasomotor symptoms. It is associated with carcinoid heart disease (CHD) in >50% of patients. We are reporting a case of a 69-year-old female who presented with congestive heart failure, platypnea-orthodeoxia syndrome with refractory diarrhea. After medical stabilization and diagnosing the female as a case of CHD with a primary tumor located at the ovary; she was planned for exploratory laparotomy, bilateral salpingo-oophorectomy, and retroperitoneal pelvic lymph node removal, followed by tricuspid valve (TV) intervention.
Møller JE, Pellikka PA, Bernheim AM, et al. Prognosis of carcinoid heart disease: analysis of 200 cases over two decades. Circulation 2005;112(21):3320–3327. DOI: 10.1161/CIRCULATIONAHA.105.553750
Castillo J, Silvay G, Weiner M. Anesthetic management of patients with carcinoid syndrome and carcinoid heart disease: the Mount Sinai algorithm. J Cardiothorac Vasc Anesth 2018;32(2):1023–1031. DOI: 10.1053/j.jvca.2017.11.027
Hollon M, Glas K, Sumler M. 4-valve heart disease and right heart failure. J Cardiothorac Vasc Anesth 2018;32(2):838–845. DOI: 10.1053/j.jvca.2017.10.019
Albåge A, Alström U, Forsblad J, et al. Quadruple bioprosthetic valve replacement in a patient with severe carcinoid heart disease. JACC Case Rep 2020;2(2):271–276. DOI: 10.1016/j.jaccas.2019.11.030
Tadokoro T, Katsuki S, Ito K, et al. Inoperable primary ovarian carcinoid led to the progression of carcinoid heart disease from right-sided to both-sided involvement. Circ Heart Fail 2017;10(1):e003719. DOI: 10.1161/CIRCHEARTFAILURE.116.003719
Connolly HM. Carcinoid heart disease: medical and surgical considerations. Cancer Control 2001;8(5):454–460. DOI: 10.1177/107327480100800511
Plöckinger U, Gustafsson B, Ivan D, et al. ENETS consensus guidelines for the standards of care in neuroendocrine tumors: echocardiography. Neuroendocrinology 2009;90(2):190–193. DOI: 10.1159/000225947
