Stuck on plaque in carcinoid heart disease and anorexigen associated valvular heart disease

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 [3]. Histopathological section showed that the valve architecture was preserved. The plaque encased the chordae tendinae.

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 [4].

Reference

  1. Caccitolo JA, Connolly HM, Rubenson DS, Orszulak TA, Schaff HV. Operation for anorexigen-associated valvular heart disease. J Thorac Cardiovasc Surg. 2001;122:656-64.
  2. Proesmans S, Van Fraeyenhove F, Dossche K, Mattelaer C, Scott B. Carcinoid heart disease: a remarkable recovery. Acta Clin Belg. 2015 Dec;70(6):453-6
  3. Connolly HM, Crary JL, McGoon MD, Hensrud DD, Edwards BS, Edwards WD, Schaff HV. Valvular heart disease associated with fenfluramine-phentermine. N Engl J Med. 1997 Aug 28;337(9):581-8.
  4. Simula DV, Edwards WD, Tazelaar HD, Connolly HM, Schaff HV. Mayo Clin Proc. 2002 Feb;77(2):139-47.