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Mailing Adress: Paulo Roberto Barbosa Evora • Rua Rui Barbosa 367/15 – Centro 14015-120 – Ribeirão Preto, SP Brasil E-mail: prbevora@cardiol.br, prbevora@fmrp.usp.br Manuscript received March 21, 2011; revised manuscript received March 21, 2011; accepted April 26, 2011. Carcinoid tumor is a rare tumor in neuroendocrine cell line, which occurs in 1.2 to 2.1 per 100,000 people per year. At diagnosis, 20% to 30% of patients have the disease disseminated and subsequent heart disease, which affects 40% of patients causing high morbidity and mortality in the carcinoid syndrome. Primary cardiac carcinoid tumors were not reported and, rarely, metastatic tumor masses were found in the myocardium, usually in conjunction with valvular involvement. It is believed that cardiac involvement occurs when serotonin and other active substances are released from liver metastases or primary ovarian carcinoid tumors, bypassing the metabolism in the liver. Carcinoid heart disease typically involves the tricuspid and pulmonary valves, causing right heart failure. Involvement of the left valve is rarely reported (<10% of patients). Thus, the mitral and aortic carcinoid disease may occur more frequently in patients with atrial septal defect or patent foramen ovale with diversion of blood from right to left. However, cardiac involvement may also occur in the absence of this diversion due to an association with bronchopulmonary carcinoid or with high levels of circulating serotonin1-3.

Valvulopatia carcinoide do coração: ainda um enigma e um desafio