An unusual cause of hypoxia: getting to the heart of the matter
File(s)
Author(s)
Hammersley, Daniel
Shamsi, Aamir
Zaman, Mohammad Murtaza
Berry, Philip
Sturridge, Lydia
Type
Journal Article
Abstract
A 63-year-old female presented to hospital with progressive exertional dyspnoea over a 6-month period. In the year preceding her admission, she reported an intercurrent history of abdominal pain, diarrhoea and weight loss. She was found to be hypoxic, the cause for which was initially unclear. A ventilation–perfusion scan identified a right-to-left shunt. Transoesophageal echocardiography (TOE) demonstrated a significant right-to-left intracardiac shunt through a patent foramen ovale (PFO); additionally severe tricuspid regurgitation was noted through a highly abnormal tricuspid valve. The findings were consistent with carcinoid heart disease with a haemodynamically significant shunt, resulting in profound systemic hypoxia. 24-h urinary 5-hydroxyindoleacetic acid (5-HIAA) and imaging were consistent with a terminal ileal primary carcinoid cancer with hepatic metastasis. Liver biopsy confirmed a tissue diagnosis. The patient was commenced on medical therapy for carcinoid syndrome. She subsequently passed away while undergoing anaesthetic induction for valvular surgery to treat her carcinoid heart disease and PFO.
Date Issued
2018-03-01
Date Acceptance
2018-03-01
Citation
Echo Research and Practice, 2018, 5 (1), pp.K7-K11
ISSN
2055-0464
Publisher
BioScientifica
Start Page
K7
End Page
K11
Journal / Book Title
Echo Research and Practice
Volume
5
Issue
1
Copyright Statement
© 2018 The authors
Published by Bioscientifica Ltd. This work is licensed under a Creative Commons
Attribution-NonCommercial-NoDerivatives 4.0
International License (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Published by Bioscientifica Ltd. This work is licensed under a Creative Commons
Attribution-NonCommercial-NoDerivatives 4.0
International License (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000428527600007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
carcinoid syndrome
patent foramen ovale
shunt
PATENT FORAMEN OVALE
DISEASE
Publication Status
Published
Date Publish Online
2018-03-01