A 76-year-old woman presenting with right heart failure is reported. The in
vestigation showed an ileal carcinoid tumour with multiple metastases and t
ricuspid regurgitation caused by a cardiac carcinoid lesion. Echocardiograp
hic study and histopathological examination revealed typical characteristic
s of carcinoid heart disease. Nevertheless, except for the cardiac symptoma
tology, the patient did not show any other clinical manifestation of the ca
rcinoid syndrome. Isolated right heart failure as the first sign of a carci
noid syndrome is rare; only two other cases have been described in the lite
rature.