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  • Title: [Progressive dyspnoea in two patients with carcinoid syndrome].
    Author: Nölting S, Nicolaus M, Behr J, Baumgartner R, Mete H, Boekstegers P, Herrmann K, Theisen D, Lehrke M, Göke B, Schirra J, Auernhammer CJ.
    Journal: Internist (Berl); 2010 Nov; 51(11):1439-45. PubMed ID: 20628718.
    Abstract:
    In patients with carcinoid syndrome, there has always to be considered cardiac impairment. We report about two patients with hepatic and bone metastases of a neuroendocrine tumor of the midgut, who suffered from progressive dyspnea. This was caused in both cases by a right-to-left atrial shunt, in case 1 based on a patent foramen ovale (PFO), in case 2 based on a secundum atrial septal defect. Symptoms were significantly reduced by percutaneous closure of PFO and ASD, respectively. Right-to-left atrial shunt was facilitated by right-sided carcinoid induced endocardial fibrosis with the consequence of severe tricuspid regurgitation, leading to an increase of right atrial pressure.
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