A 45-year-old woman presents with sudden attacks of wheezing, shoness of breath, episodic hot flashes, abdominal cramps and diarrhea. Physical examination shows facial redness, as well as hepatomegaly and pitting edema of the lower legs. A 24-hour urine specimen reveals elevated levels of 5-hydroxyindoleacetic acid (5-HIAA). A CT scan of the abdomen demonstrates multiple 2- to 3-cm nodules throughout the liver and a 2-cm nodule in the jejunum. An echocardiogram would be most expected to demonstrate which of the following?

Carcinoid syndrome reflects the release of active tumor products and features diarrhea, flushing, bronchospasm and skin lesions. Carcinoid hea disease typically affects the right hea, causing changes in the pulmonary and tricuspid valves. It is associated with intestinal carcinoids that have metastasized to the liver. The cardiac lesions consist of plaque-like deposits of dense fibrous tissue on the tricuspid and pulmonary valves, producing tricuspid insufficiency and pulmonic stenosis. Elevated levels of HIAAA, a metabolite of serotonin, are diagnostic of carcinoid syndrome. The other choices are not complications of carcinoid syndrome.