BACKGROUND: Carcinoid heart disease (CHD) is the rare but serious complication of a paraneoplastic syndrome caused by carcinoid tumors predominantly affecting right-sided cardiac valves and valvular apparatus, leading to significant valvular dysfunction. Multidisciplinary management is paramount for optimal patient outcomes. CASE SUMMARY: A 50-year-old man with chronic flushing, diarrhea, and weight loss was diagnosed with CHD. Echocardiography demonstrated resultant severe tricuspid and pulmonary valve degeneration. He underwent dual-valve replacement, followed by liver debulking surgery with good initial results. Subsequently early, significant valve degeneration occurred. DISCUSSION: CHD occurs in up to 50% of patients with cardiac syndrome, and insidious symptom onset means diagnosis often delayed. Early investigation and prompt management are therefore imperative to prevent progression and plan multistaged interventions.