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

Trace the path of the offending chemicals. A carcinoid tumour pours serotonin and related amines into the venous blood. This blood returns to the right heart first, so the right-sided endocardium and valves soak in high amine concentrations and react by laying down fibrous plaques. Crucially, the lung then metabolises and inactivates these amines, which is why the left heart escapes harm in most patients. The result is a coating of fibrous, collagen-rich, smooth-muscle plaque on the right ventricular lining, the tricuspid valve, and the pulmonary valve. Functionally this stiffens and tethers the tricuspid valve, producing regurgitation, and narrows the pulmonary outflow, producing pulmonary stenosis. Reading the options through this lens, the best match is the one naming fibrous endocardial thickening of the right ventricle, tricuspid valve, and pulmonary valve. The choice mentioning endometrial thickening is a misprint and clinically meaningless, and severe tricuspid stenosis is not the rule. The option stressing elastic deposits is wrong because the plaques are notably deficient in elastic tissue, and the calcification option describes degenerative valve disease, not carcinoid plaque. \[\boxed{\text{Fibrous endocardial thickening of RV, tricuspid and pulmonary valve}}\]