The Syndrome of Carcinoid and Acquired Valve Lesions of the Right Side of the Heart

Recent papers by Biörck and Rosenbaum have revived interest in the rare disease characterized pathologically by carcinoid of the small intestine, metastases to the liver, acquired nonrheumatic disease of the tricuspid and pulmonic valve, and angiomas in the skin. Clinically the condition is characterized by dramatic episodes of flushing, mottling of the skin, diarrhea, dyspnea and ultimately by congestive failure. Probably 5-hydroxytryptamine (serotonin) liberated from the carcinoid tumors induces the vascular changes. The suggestion is set forth that an antagonist to this compound might reduce the symptoms and perhaps favorably affect the course of the disease. Two cases are reported.