{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:17:26Z","timestamp":1778602646960,"version":"3.51.4"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Carcinoid heart disease is a rare complication of neuroendocrine tumours caused by chronic exposure to vasoactive substances, leading to progressive valvular dysfunction and right heart failure. The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in this context remains controversial, as it may exacerbate carcinoid crisis by bypassing the pulmonary metabolism of these vasoactive mediators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We describe a patient with clinical suspicion of a neuroendocrine tumour and severe carcinoid heart disease who developed refractory cardiogenic shock. VA-ECMO was initiated as rescue support but resulted in an abrupt haemodynamic collapse, the patient subsequently progressed to multiorgan failure and died. This case illustrates the paradoxical and potentially deleterious effects of extracorporeal support in the setting of carcinoid physiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In the setting of a carcinoid crisis with cardiogenic shock secondary to right ventricular failure, VA-ECMO may appear as a potential option for haemodynamic support. However, by reducing pulmonary blood flow\u2014and consequently the degradation of vasoactive substances\u2014its use may worsen the patient\u2019s clinical condition. Therefore, a multidisciplinary approach involving cardiology, acute cardiac care, intensive care, oncology, gastroenterology, endocrinology, and pathology teams is essential, both in diagnosis and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag272","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:58:32Z","timestamp":1777377512000},"source":"Crossref","is-referenced-by-count":0,"title":["Case report: VA-ECMO as a bridge to collapse in carcinoid heart disease"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8954-6000","authenticated-orcid":false,"given":"Ana Alicia","family":"Ala\u00f1\u00f3n Hern\u00e1ndez","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valladolid , Avenida de Ram\u00f3n y Cajal 3, 47003 Valladolid (Castilla y Le\u00f3n) ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Tobar Ruiz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valladolid , Avenida de Ram\u00f3n y Cajal 3, 47003 Valladolid (Castilla y Le\u00f3n) ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV) , 28029 Madrid ,","place":["Spain"]},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Valladolid (IBioVAll) , 47003 Valladolid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Francisco","family":"Gil Fernandez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valladolid , Avenida de Ram\u00f3n y Cajal 3, 47003 Valladolid (Castilla y Le\u00f3n) ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Garc\u00eda de Casasola Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valladolid , Avenida de Ram\u00f3n y Cajal 3, 47003 Valladolid (Castilla y Le\u00f3n) ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Plaza Mart\u00edn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valladolid , Avenida de Ram\u00f3n y Cajal 3, 47003 Valladolid (Castilla y Le\u00f3n) ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV) , 28029 Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"2026051212043290000_ytag272-B1","doi-asserted-by":"crossref","first-page":"662","DOI":"10.3390\/cancers14030662","article-title":"Carcinoid crisis: a misunderstood and unrecognized oncological emergency","volume":"14","author":"Bardasi","year":"2022","journal-title":"Cancers (Basel)"},{"key":"2026051212043290000_ytag272-B2","first-page":"413","article-title":"Hedinger syndrome-lessons learnt: a single-center experience","volume":"10","author":"El Gabry","year":"2023","journal-title":"J Cardiovasc Dev Dis"},{"key":"2026051212043290000_ytag272-B3","doi-asserted-by":"crossref","first-page":"945","DOI":"10.21470\/1678-9741-2020-0656","article-title":"Hedinger syndrome with intraoperative carcinoid crisis - understanding the pathophysiology for a successful management","volume":"37","author":"Guerrero-Becerra","year":"2022","journal-title":"Braz J Cardiovasc Surg"},{"key":"2026051212043290000_ytag272-B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000547348","article-title":"The use of hemoadsorption in cancer-related complications","author":"Premuzic","year":"2025","journal-title":"Blood Purif"},{"key":"2026051212043290000_ytag272-B5","doi-asserted-by":"crossref","first-page":"3234","DOI":"10.21037\/jtd.2019.08.71","article-title":"Hedinger syndrome: first experience and two-year follow-up in patients with carcinoid heart disease","volume":"11","author":"El Gabry","year":"2019","journal-title":"J Thorac Dis"},{"key":"2026051212043290000_ytag272-B6","doi-asserted-by":"crossref","first-page":"4229","DOI":"10.1093\/eurheartj\/ehac244","article-title":"2022 ESC guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS)","volume":"43","author":"Lyon","year":"2022","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal - 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