Stuck on plaque in carcinoid heart disease and anorexigen associated valvular heart disease
“Stuck on plaque” is the description given to the lesions on the tricuspid valve in carcinoid heart disease and anorexigen associated valvular heart disease. The lesions appear “stuck on” the leaflets without inflammation or damage to the underlying valve structure [1, 2].
An article in NEJM (free full text) gives the image of a stuck on plaque on an excised mitral valve in fenfluramine associated valvular heart disease . Histopathological section showed that the valve architecture was preserved. The plaque encased the chordae tendineae.
C J Knott-Craig et al have reported on surgical management of ten patients with carcinoid heart disease. They have also described the “stuck on” appearance of the plaque on the undersurface of tricuspid leaflet .
A large surgical pathology series in Mayo Clinic Proceedings on 139 valves from 75 patients over two decades also describes the lesions in carcinoid heart disease .
C J Knott-Craig, H V Schaff, C J Mullany, L K Kvols, C G Moertel, W D Edwards, G K Danielson. Carcinoid disease of the heart. Surgical management of ten patients. J Thorac Cardiovasc Surg. 1992 Aug;104(2):475-81.
Simula DV, Edwards WD, Tazelaar HD, Connolly HM, Schaff HV. Mayo Clin Proc. 2002 Feb;77(2):139-47.