Coronary artery spasm and cardiac arrest in carcinoid heart disease

Abstract Previously reported cardiac manifestations of carcinoid disease include right-sided valvular dysfunction and vasomotor disturbances. This report describes a 62-year-old white man who had electrocardiographlcally documented widespread elevation of the S-T segment, arrhythmias, and cardiac arrest after exercise. Noninvasive and laboratory studies confirmed the diagnosis of malignant carcinoid disease with tricuspid valve involvement. Coronary anglography revealed mild atherosclerosis. Thus, coronary artery spasm is a previously unrecognized manifestation of carcinoid heart disease and introduces what may be an Important relationship of endogenous, excessive vasoactlve amines to human coronary vasospasm.