What is carcinoid crisis?
Carcinoid crisis is a rare unpredictable clinical emergency associated with carcinoid syndrome. Carcinoid crisis causes extreme changes in blood pressure, heart rate and breathing, due to excessive hormone release. It can be triggered when a person with neuroendocrine cancer experiences significant stress, undergoes biopsies, anaesthetic, liver directed therapies or peptide receptor radionuclide therapy (PRRT).
What are the symptoms associated with carcinoid crisis?
- Low or high blood pressure
- Wheezing/shortness of breath
- Fast heart rate
- High body temperature
- Altered mental state
- Intense flushing
- Abdominal pain
In extreme cases carcinoid crisis may cause loss of consciousness and be life threatening.
What are risk factors for carcinoid crisis
It is difficult to predict the risk for carcinoid crisis occurring. The following are considered potential risk factors:
- Carcinoid syndrome
- Carcinoid heart disease
- Large amount of neuroendocrine cancer in the body (high tumour burden)
- High Chromogranin A (CgA) levels
- High urinary 5-HIAA levels
Management and Treatment of carcinoid crisis
If you are having a procedure, it is vital healthcare professionals involved in your care are aware you have carcinoid syndrome. This will ensure the appropriate management is organised to prevent a carcinoid crisis. People with a neuroendocrine cancer that are known to have a carcinoid syndrome, can safely undergo procedures provided the procedure is managed by an anesthetist who has an understanding and plan to prevent and manage carcinoid crisis.
Carcinoid crisis can be prevented and managed with somatostatin analogue medications via infusion or injection. (For more detailed information refer to Anaesthesia Fact Sheet)
Additional Resources
- Anaesthesia Fact Sheet
- Medical Alert Card (example below)
If you need further support or information about carcinoid syndrome and neuroendocrine cancer, contact the NET nurses at NeuroEndocrine Cancer Australia on 1300 287 363 Monday-Friday 9am-5pm.
