Complex Tricuspid and Pulmonic Carcinoid Heart Disease With Timely Surgical Repair.

A 63-year-old man with a history of hypertension, prediabetes, and sleep apnea presented with pedal edema, weight loss, and flushing. Laboratory work revealed elevated B-type natriuretic peptide and normocytic anemia. Echocardiography showed right ventricular enlargement, severe tricuspid valve regurgitation, and thickened tricuspid valve leaflets, raising suspicion for carcinoid heart disease. Further testing confirmed a neuroendocrine tumor with liver metastasis. Despite somatostatin therapy, the patient's symptoms were refractory to diuretics. Surgical intervention with tricuspid and pulmonary valve replacement was undertaken. Postoperatively, the patient demonstrated substantial improvement in functional tolerance and quality of life. This case highlights the importance of surgical intervention in advanced carcinoid heart disease.