Sunflower Hospital Nagpur | Dr Jay Deshmukh :- The most important reason to diagnose and treat thyroid disease is to prevent cardiovascular diseases that can result due to it. Thyroid disorders are more common in women. The thyroid hormone is known to regulate every function of the human body including the heart. Any disease related to thyroid function can affect the functioning of the heart and can lead to significant deterioration of the cardiac function. Hence almost all patients who have cardiovascular diseases should also assess their thyroid functions.
What are the common thyroid disorders ?
- If the thyroid gland produces too less of the hormone, it is known as Hypothyroidism. If the thyroid gland produces excess of the hormone, it is known as hyperthyroidism. Both Hypothyroidism and hyperthyroidism can adversely affect the cardiovascular functions.
How do thyroid conditions affect the heart ?
- In Hypothyroidism the heart contracts slowly and feebly and the blood vessels often get very stiff. In hyperthyroidism the heart pumps blood more vigorously and at a faster rate and thus consumes more oxygen and energy. This may lead to an irregular heart rhythm known as atrial fibrillation.
How does Hypothyroidism affect the heart function ?
- Sunflower Hospital Nagpur | Dr Jay Deshmukh :- Due to deficiency of thyroid hormone, the heart pumps blood less effectively, eventually the heart muscle gets weakened. The heart muscle does not relax fully after every heart contraction and can lead to heart failure. The blood vessels can get stiff leading to hypertension. Hypothyroidism is at times a very subtle condition and the symptoms may not be very obvious at all times. The common features could be new onset heart failure or worsening of heart failure. Low pulse rate, diastolic hypertension, swelling over feet and face and worsening of coronary artery disease are common features. There could be collection of fluid around the heart known as pericardial effusion.The blood Cholesterol levels are invariably high in uncontrolled hypothyroidism further contributing to coronary artery disease.
How does hyperthyroidism influence your heart ?
- Sunflower Hospital Nagpur | Dr Jay Deshmukh :- Hyperthyroidism causes increase in heart rate, may cause systolic hypertension and cause worsening of angina and heart failure. Irregular heart beats manifesting as atrial fibrillation are common in hyperthyroidism. Patients may feel out of breath with minimal effort . Hyperthyroidism leads to increased appetite associated with weight loss, excessive sweating and intolerance to warm weather.
How are thyroid diseases diagnosed ?
- The thyroid function tests are the only tests that measure the thyroid functions .These are simple blood tests that measure the TSH, T4 and T3 levels in blood. The thyroid peroxidase antibodies confirm the autoimmune nature of the disease. A complete lipid profile estimation is necessary in hypothyroidism individuals. Patients with cardiovascular symptoms would require ECG and Echocardiogram.
What about thyroid disease in pregnancy ?
- Sunflower Hospital Nagpur | Dr Jay Deshmukh :- Besides gestational diabetes, thyroid disease in pregnancy is also of great importance. Proper optimisation of medical therapy in pregnancy is extremely important to have a healthy baby. The normal values of thyroid functions are quite different in pregnancy. Certain drugs like Neomercazole may not be safe in first 3 months of pregnancy. Radio isotope Iodine is not safe in pregnancy. The requirement of thyroid hormone may increase as the pregnancy progresses in individuals with hypothyroidism.
When to suspect hyperthyroidism ?
- Any person who sweats excessively, has weight loss inspite of excess appetite and good food intake, palpitations and increased heart beats , thyroid swelling , prominent eyeball and staring looks and fine tremors of out stretched hands can be suffering from hyperthyroidism.
When to suspect hypothyroidism ?
- Increased weight, puffiness of face, swelling over legs, hoarse voice, feeling sleepy all the time, lethargy, loss of memory and sleeping excessively, low pulse rate and loss of memory and menstrual irregularities in women can make hypothyroidism likely in that individual.
Are thyroid disorders easily treatable ?
- One should remember that thyroid hormone deficiency causing hypothyroidism may require treatment on lifelong basis. The tablet is taken on empty stomach early morning every day. In hyperthyroidism there are options of medications in tablets form or radioactive iodine therapy in selected cases or surgical removal of the thyroid gland.Thyroid hormone is essential for proper and normal heart function. Excess or deficiency of the thyroid hormone can affect the heart function adversely. Early recognition of thyroid disorders in patients with cardiovascular diseases is extremely imperative to improve the overall outcome of these individuals.
Author: Dr Jay Deshmukh
Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.