Carcinoid syndrome is the term applied to a constellation of symptoms mediated by a variety of humoral factors produced by the well-differentiated neuroendocrine tumours (NET) localised usually in the gastrointestinal tract and the lungs. This syndrome includes a characteristic triad of diarrhea, flushing and cardiac disease. This cardiopathy occurs in 20 % of the cases and prevails on the right side of the heart. It evolves to a potentially severe heart failure. Therefore, early diagnosis and appropriate cardiac care are crucial to improve the prognosis of these patients. We report a case of a carcinoid syndrome with a trivalvular insufficiency and cardiac decompensation which required surgical replacement of the tricuspid and aortic valves.