Case Report with Clinical, Haemodynamic and Operative Findings

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Abstract
Carcinoid disease is described in a woman with somewhat atypical symptoms. She experienced dyspnoea on exertion but no flushing or diarrhoea. Clinical signs suggested pericardial tamponade with congestion of liver and jugular veins, faint heart sounds, and enlarged heart shadow showing feeble pulsations. Pressure curves during heart catheterization were consistent with either pericarditis or tricuspid regurgitation. Angiography showed a thick atrial wall and, as no fluid was retrieved by pericardial puncture, she was operated on with the diagnosis “cardiac tumour” in mind. During manipulation of the heart, severe flushing of the arms was noted. Urinalysis showed increased amounts of 5-hydroxyin-dolacetic acid. The post operative course has been complicated by increasing signs of tricuspid insufficiency as well as the development of probable pulmonic valve regurgitation.

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