Echocardiogram apical 4-chamber showing tricuspid valve pathology in carcinoid heart disease

Four chamber view from a 2-D echocardiogram in a patient with carcinoid syndrome shows thickening and immobility of the tricuspid leaflets which remain open in systole as a result of severe fibrosis. The right atrium and ventricle are dilated due to the tricuspid regurgitation.