Cardiac Vein Involvement in Carcinoid Syndrome: Possible Evidence of Retrograde Blood Flow in Cardiac Veins in Tricuspid Insufficiency

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Abstract
Cardiac vein involvement was found in four patients with carcinoid heart disease. In one patient, the coronary sinus at the valve was affected. In three patients, other cardiac veins were also involved. These included the atrial wall sinusoids, the great cardiac vein, the anterior and posterior interventricular veins, the anterior and small cardiac veins, and the posterior vein of the left ventricle. The coronary sinus seems to be the only cardiac vein previously reported to be affected by carcinoid fibrosis. The cardiac vein lesions probably occur when the malignant carcinoid syndrome is complicated by tricuspid insufficiency and regurgitation of blood into the venous system of the heart. The cardiac vein lsions might represent a “marker” to indicate the extent of retrograde venous blood flow in some of these patients.

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