Question

The characteristic pathological finding in carcinoid heart disease is:

• A. Fibrous endocardial thickening of the right ventricle, tricuspid valve and pulmonary valve
• B. Endometrial thickening of the tricuspid valve with severe tricuspid stenosis
• C. Collagen rich, elastic deposits in endocardium of right ventricle and pulmonary valve
• D. Calcification of the tricuspid and pulmonary valve

Hint:

Serotonin hits the right heart; the lung protects the left.

Answer 1

The Correct Option is A

Step 1: Recall the mechanism. Carcinoid tumours release serotonin and other vasoactive amines. When these reach the heart, they trigger deposition of fibrous tissue on the endocardium and valves.
Step 2: Locate the lesions. The mediators are inactivated in the lung, so the right side of the heart bears the damage while the left side is usually spared. The classic targets are the right ventricular endocardium, the tricuspid valve, and the pulmonary valve.
Step 3: Describe the lesion. The deposits are plaque-like fibrous (smooth muscle and collagen) thickenings of the endocardium and valve leaflets. This leads to tricuspid regurgitation and pulmonary stenosis.
Step 4: Match to the option. Option A states fibrous endocardial thickening of the right ventricle, tricuspid valve, and pulmonary valve, which is exactly the described lesion.
Step 5: Reject the others. Option B uses endometrial which is a typo and unrelated, and stenosis is not the typical tricuspid lesion (regurgitation is). Option C wrongly stresses elastic deposits; the plaques are poor in elastic fibres. Option D describes calcific degeneration, which is not the carcinoid pattern.
Conclusion: The finding is fibrous endocardial thickening of the right heart structures. The answer is option A.