THE HEART AND THYROID-DISEASE

This article discusses the effects of thyroid hormone on the heart, ca rdiovascular symptoms and signs in elderly patients with hyperthyroidi sm and hypothyroidism, and the diagnosis and therapy of hyperthyroidis m and hypothyroidism in elderly patients. Cardiovascular symptoms of h yperthyroidism include palpitations, angina pectoris, and dyspnea on e xertion, orthopnea, or paroxysmal nocturnal dyspnea. Atrial fibrillati on or congestive heart failure may be the only clinical manifestation of hyperthyroidism in elderly patients with apathetic hyperthyroidism. Atrial fibrillation with a rapid Ventricular rate due to hyperthyroid ism should be treated with propranolol to control the rapid ventricula r rate. Elderly patients with coronary artery disease and hypothyroidi sm should be treated cautiously with thyroid hormone replacement to av oid precipitating or exacerbating angina pectoris, precipitating acute myocardial infarction, and precipitating or aggravating ventricular a rrhythmias or congestive heart failure.