The cardiovascular manifestations of
hyperthyroidism include an increase in heart rate, stroke volume, and cardiac output. Peripheral vascular resistance is decreased, and thus there is a widened pulse pressure. All of these lead to an increase in myocardial oxygen consumption and therefore may precipitate angina. Other potential symptoms include palpitations, tachycardia, presyncope or syncope, and shortness of breath on exertion. The effects of hyperthyroidism lead to increased myocardial work and oxygen consumption and therefore may precipitate angina and arrhythmias.
Typical clinical scenario: An elderly woman (hyperthyroidism is 4-8 times as common in women as in men) presents with weight loss, weakness, and tachycardia and may or may not have angina or atrial fibrillation (15%). Examination shows tremor of fingers and tongue; goiter may or may not be present.
Common physical findings are tachycardia and a bounding pulse with a wide pulse present with forceful apical pulse and a systolic ejection murmur due to increased flows. Cardiac arrhythmias are common, particularly supraventricular tachycardia and atrial fibrillation. Atrial fibrillation occurs in 10% to 20% of patients with hyperthyroidism. Therefore, thyrotoxicosis should always be suspectedin patients with atrial fibrillation and the thyroid function should be checked. Findings of hyperthyroidism: tachycardia, bounding pulse, forceful apical impulse, widened pulse pressure, and systolic ejection murmur. Cardiac arrhythmias are common, especially atrial fibrillation. Thyrotoxicosis in patients with atrial fibrillation.
Treatment of underlying hyperthyroidism usually leads to reversal of cardiac symptoms. If atrial fibrillation is present, the risk of embolization is high and anticoagulation should be instituted. Cardioversion should not be attempted until a euthyroid state is achieved.
Hypothyroidism leads to cardiac enlargement and decreased function due to infiltration of the myocardium with mucoproteins. This disorder decreases the metabolic rate and circulatory demand and causes bradycardia, decreased myocardial contractility and stroke volume, and an increase in peripheral resistance. In one-third of patients, a pericardial effusion is present. The cardiomyopathy of hypothyroidism is reversible if detected early. The hypothyroid state can increase cholesterol levels and accelerate atherosclerosis.
Typical clinical scenario: An elderly patient presents with depression, lethargy, and slowed mentation. Examination shows hair loss on the scalp and eyebrows and macroglossia. Sinus bradycardia usually is present. Chest radiography shows increased cardiac size. To prevent Hypothyroidism you need to
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Electrocardiography shows low voltage of QRS with prolonged intervals of QRS, PR, and QT. Hypothyroidism may lead to dilated cardiomyopathy. There may be cardiac enlargement due to the myocardial disease or to a commonly found pericardial effusion. The volume of pulses is decreased because of a decrease in myocardial contractility. Physical findings in hypothyroidism: cardiac enlargement, reduced myocardial contractility, and pericardial effusion (this occurs in a third of patients). Heart failure is less common, but it is reversible if found early. Atherosclerosis is accelerated.
Treating the underlying cause likely leads to reversal of cardiac involvement. To treat Hypothyroidism you must restore you hormone balance. Use special meds to do it.