A 64-year-old woman presents with rapidly progressive dyspnea and severe right-sided heart failure. What are the abnormal findings, and which underlying disease should be suspected?

Study the Loop

Assess the loop systematically before you commit.

Mystery Echo

Explanation

Carcinoid heart disease.

There is marked tricuspid regurgitation with markedly thickened, retracted, and nearly immobile tricuspid valve leaflets. This appearance is highly suggestive of carcinoid heart disease, particularly when the pulmonary valve is also involved. In this patient, a small-bowel neuroendocrine tumor was subsequently confirmed.

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