CLINICAL MANIFESTATIONS OF CARCINOID HEART DISEASE AND POSSIBILITY OF CORRECTIVE SURGERY

Abstract

Introduction: Carcinoid heart disease is a rare condition that occurs as a consequence of carcinoid syndrome, characterized by neuroendocrine tumors that secrete vasodilatory substances, such as serotonin. These substances can affect the heart, especially the right valves, leading to valvular dysfunction and the development of heart failure. Clinical manifestations include heart murmurs, edema, shortness of breath, and cyanosis. Complications occur mainly due to involvement of the tricuspid and pulmonary valves, which impairs venous return and pulmonary circulation. Objective: To evaluate the clinical manifestations of carcinoid heart disease and the feasibility of corrective surgical approaches, through a critical analysis of recent literature. Methodology: The methodology was based on the PRISMA checklist and involved the search for articles published in the last 10 years in the PubMed, SciELO, and Web of Science databases. Five descriptors were used: "carcinoid heart disease", "neuroendocrine tumors", "valvular surgery", "heart failure" and "surgical treatment". The search included clinical studies and reviews, with articles in English and Portuguese. Inclusion criteria were: studies that addressed the surgical treatment of carcinoid heart disease, articles that discussed clinical manifestations in adults and studies that provided data on postoperative response. Exclusion criteria were: studies with children, articles that did not involve corrective surgery and studies outside the scope of carcinoid heart disease. Results: The results indicated that the most frequent clinical manifestations include right valvular insufficiency, respiratory difficulties and symptoms of heart failure. The surgical approach, although effective in selected cases, faces challenges due to disease progression and involvement of cardiac tissues. In many cases, surgery cannot completely reverse the damage, but it can improve the patient's survival and quality of life. Conclusion: Carcinoid heart disease represents a major clinical and surgical challenge, given the complexity of the associated cardiac lesions. Corrective surgery, when possible, offers significant relief, but the long-term prognosis depends on the severity of the cardiac lesions and the multidisciplinary treatment.