All are true about cardiac manifestations of carcinoid syndrome, EXCEPT:

The cardiac disease is due to the formation of fibrotic plaques involving the endocardium. The dense fibrous deposits are most commonly on the ventricular aspect of the tricuspid valve and less commonly on the pulmonary valve cusps. Overall, in patients with carcinoid hea disease, 97% have tricuspid insufficiency, 59% tricuspid stenosis, 50% pulmonary insufficiency, 25% pulmonary stenosis, and 11% left-side lesions. 80% of patients with cardiac lesions develop hea failure. Lesions on the left side are much less extensive and most frequently affect the mitral valve. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 3062