The heart and thyroid disease.

This article discusses the effects of thyroid hormone on the heart, cardiovascular symptoms and signs in elderly patients with hyperthyroidism and hypothyroidism, and the diagnosis and therapy of hyperthyroidism and hypothyroidism in elderly patients. Cardiovascular symptoms of hyperthyroidism include palpitations, angina, pectoris, and dyspnea on exertion, orthopnea, or paroxysmal nocturnal dyspnea. Atrial fibrillation 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 hyperthyroidism should be treated with propranolol to control the rapid ventricular rate. Elderly patients with coronary artery disease and hypothyroidism should be treated cautiously with thyroid hormone replacement to avoid precipitating or exacerbating angina pectoris, precipitating acute myocardial infarction, and precipitating or aggravating ventricular arrhythmias or congestive heart failure.