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How Does The Thyroid Affect The Heart

Hyperthyroidism And Your Heart

Podcast – How Does The Thyroid Affect The Heart? with Dr. Steven Masley

Hyperthyroidism occurs when your thyroid gland makes too much thyroid hormone or your dose of thyroid medicine is too high. The excess hormone “speeds up” virtually every system in your body. The symptoms often include nervousness, palpitations caused by a fast heart rate, feeling hot when others are comfortable, trouble sleeping, and weight loss despite being hungry all the time.

If left untreated, hyperthyroidism does more to your heart than simply making it beat faster. The excess thyroid hormone makes it work harder, too. This can lead to any of several problems:

Abnormal heart rhythms. Several heart rhythm disturbances can result from overstimulation of the thyroid. The most common are sinus tachycardia, an abnormally fast heart rate that tops 100 beats per minute, and atrial fibrillation, a disorganized rhythm in the heart’s upper chambers.

High blood pressure. In hyperthyroidism, blood vessels relax, lowering diastolic blood pressure . But an excess of thyroid hormone also increases the force of the heart’s contractions, leading to an increase in systolic pressure .

Chest pain. Whenever the heart beats more forcefully and pumps more blood, the heart muscle needs more oxygen. If a person with hyperthyroidism also has clogged coronary arteries, they may experience the chest pain known as angina, which occurs when narrowed coronary arteries can’t carry all the extra blood the heart muscle demands.

I Th Effects On The Systemic Vascular System

Systemic vascular resistance index at rest in untreated patients with hyperthyroidism, during -blockade monotherapy, after restoration of euthyroidism with antithyroid drugs, and in age- and sex-matched, healthy control subjects. Data are shown as mean values ± sem.

This hemodynamic effect of T3 in the periphery markedly contributes to the increased cardiac contraction. Studies using heterotopic cardiac isographs have shown that T3-induced changes in protein synthesis and cardiac growth primarily result from secondary changes in cardiac work . In contrast, T3-induced changes in myosin isoenzyme predominance occur to the same extent in the heart in situ and in the heterotopic isographs . Thus, T3-induced hemodynamic effects originating in the periphery may influence increases in total protein synthesis and cardiac hypertrophy.

In hyperthyroid animals, arterial resistance decreases and venous tone increases, leading to an augmented return of blood to the heart . The effects of T3 on venous compliance and blood volume displayed in hyperthyroid calves include an increase in mean circulatory filling pressure, no change in blood volume, and a decrease in venous compliance, whereas hypothyroid animals showed a decrease in mean circulatory filling pressure and blood volume but no change in venous compliance.

Help Your Heart Stay Healthy

Monitoring your thyroid function is just one way you can prevent heart problems, especially as you get older. At Phoenix Heart, our cardiologists perform comprehensive diagnostic testing for heart-related symptoms, getting to the root cause of symptoms so your care can be tailored to your needs. If youre having any type of unusual heart symptoms or if its been a while since youve had a cardiac evaluation, call the office or use our online form to schedule an appointment today.

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Ii Cardiovascular Mechanisms Of Ths

A significant effect of THs on the heart results from an interaction with specific nuclear receptors in cardiac myocytes. However, rapid TH effects on ion transport functions have been elicited in isolated cardiac myocytes and may be independent of protein synthesis. Under such circumstances, THs do not appear to function by first binding to nuclear receptors. However, such proposed extranuclear effects are less well characterized than are the interactions of THs with nuclear receptors. Overall, changes in TH status influence cardiac action by three different routes: 1) the biologically relevant TH, T3, exerts a direct effect on cardiac myocytes by binding to nuclear T3 receptors influencing cardiac gene expression 2) T3 may influence the sensitivity of the sympathetic system and 3) T3 leads to hemodynamic alterations in the periphery that result in increased cardiac filling and modification of cardiac contraction . In contrast to humans , rodents do not express the type 2 iodothyronine deiodinase in their myocardium, and conversion of T4 to T3 does not occur to any measurable degree in rodent cardiac myocytes .

Heart Failure Caused By Hypothyroidism

Effects of Hypothyroidism: Thinning Hair, Heart Attack and ...

Heart failure is the final common pathway of all different kinds of negative events that happen to the cardiovascular system, such as untreated hypertension and diabetes, and heart failure is the state you end up in when these types of stresses have negatively impacted heart function, explains Ann Bolger, MD, American Heart Association spokesperson and William Watt Kerr Professor of Medicine at the University of California, San Francisco.

And no matter how they got there, this population of patients is very vulnerable.

Hypothyroidism is a disorder that interferes with the efficiency of body functions, such as muscular function and aerobic capacity, and heart patients are the ones who can least afford any additional negative effects, continues Bolger.

I dont think hypothyroidism would be well-tolerated by almost anyone, but most of us are in the happy circumstance where nature gives us so many different layers of coping mechanisms that we can defend ourselves in other ways, she adds. Hypothyroidism, however, is a total body challenge. Its not hard to understand how it can have a negative impact on heart patients.

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Heart Failure And Hypothyroidism

As described earlier, hypothyroidism can affect cardiac contractility, which is often diastolic in nature, and impair cardiac muscle relaxation. Associated diastolic hypertension and sometimes-coexistent coronary artery disease further affect myocardial diastolic function. Cardiac echocardiography has demonstrated impaired relaxation in patients with overt and subclinical hypothyroidism. In addition, early impaired relaxation has been demonstrated by prolongation of the isovolumetric relaxation time and reduction in the E/A ratio in subclinical hypothyroidism. The E/A ratio is a ratio of early to late ventricular filling velocities, and a reduced E/A ratio signifies diastolic dysfunction from impaired relaxation. Consequently, it results in a state of low cardiac output with decreased heart rate and stroke volume. It is well known that protein-rich pericardial and/or pleural effusion often occurs in hypothyroidism as a result of increased vascular permeability. In advanced heart failure and shortly after myocardial infarction, the conversion of T4 to T3 decreases. Since T3 is the main regulator of gene expression in myocardial muscle, this decrease has been thought to affect myocardial contractility and remodeling. Low free T3 levels also have been associated with increased mortality in patients with heart disease.

Circulatory And Cardiovascular Systems

Hypothyroidism slows your heart rate and weakens your heartbeat, making your heart less efficient at pumping blood out to your body. This can make you short of breath when you exercise. By narrowing your arteries, this condition can also raise blood pressure.

Hypothyroidism can lead to high cholesterol. Together, high blood pressure and high cholesterol can increase your risk for heart disease.

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Hyperthyroidism And Atrial Fibrillation Treatments

The most devastating aspect of atrial fibrillation is stroke, Tomaselli says. That’s because atrial fibrillation increases the risk for developing blood clots in the heart. Doctors often prescribe anticoagulants , while they try to get the heart back to its normal rhythm and reduce this atrial fibrillation risk. They might also prescribe drugs to slow down the heart and manage the symptoms of the arrhythmia, like beta-blockers and calcium channel blockers.

Depending on the severity and persistence of the hyperthyroidism, treatment options include anti-thyroid medications, radioactive iodine, and beta-blockers, Dr. Wexler says.

One of the drugs used to treat atrial fibrillation is Cordarone , which sets the heart back to a normal rhythm. But the use of amiodarone can negatively affect the thyroid: Its high iodine content causes many cases of hypothyroidism as well as some cases of hyperthyroidism, according to Tomaselli.

Fixing thyroid abnormalities certainly makes atrial fibrillation easier to manage, Tomaselli says. If you have atrial fibrillation and hyperthyroidism along with no other risk factors, then my expectation is that well be able to fix your thyroid problem and fix your afib.

How Each Part Of The Body Is Affected By The Thyroid

Mayo Clinic Minute: How the thyroid affects the heart

The thyroid is a gland that sits on the front of your neck, just below your Adams apple. And while its only two inches long, it can control many of your bodys essential functions. Thyroid hormones are used throughout your body, affecting a wide range of activities, including metabolism, growth and development, and body-temperature management.

Depending on how much or how little hormone your thyroid makes, you may often feel restless or tired, or you may lose or gain weight. Women are more likely than men to have thyroid conditions, especially right after pregnancy and after menopause.

So, what body systems does the thyroid affect?

  • Digestive Tract
  • The rate at which you digest your food is affected by your thyroid. Thyroid dysfunction can cause it to either speed up or slow downeach having its own set of symptoms.
  • Circulatory System
  • Thyroid hormones affect your heart rate, blood vessel elasticity, and cholesterol levels.

Your thyroid and the hormones it produces have a significant impact on your overall health. Therefore, people with thyroid issues, such as hyperthyroidism or hypothyroidism, can experience a wide range of symptoms. Lets take a closer look at how your thyroid affects each system and function and how each one could be impacted by thyroid dysfunction.

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What Tests Will I Need

Your doctor will start with a physical exam and questions about your symptoms and health history. From there, you’ll likely need different kinds of tests.

Thyroid tests. You’ll start with blood tests to check your levels of:

  • Thyroid stimulating hormone , which is made by the pituitary gland and tells your thyroid how much hormone to make. Low TSH usually means you have an overactive thyroid.
  • Thyroid hormones, called T3 and T4. If they’re high, you likely have hyperthyroidism.

From there, you may get other tests, like imaging or more bloodwork, to look for what’s causing the problem.

AFib tests. You may get:

  • Electrocardiogram, also called an ECG or EKG, to look at the electrical signals in your heart. It’s the main test for AFib and takes just a few seconds. In some cases, you’ll get a portable EKG to measure activity over a longer stretch of time.
  • Echocardiogram, a video image of your heart that lets your doctor look for blood clots
  • Stress test, which looks at how your heart reacts to exercise
  • Chest X-ray to look at your heart and lungs

E Summary And Conclusions

Thyroid hormones influence cardiac performance by genomic and non-genomic effects and increase cardiac output by affecting stroke volume and heart rate. Short-term hyperthyroidism is characterized by a high cardiac output state with a remarkable increase in heart rate and cardiac preload and a reduction in peripheral vascular resistance, resulting in a hyper dynamic circulation. However, patients with untreated overt and subclinical hyperthyroidism are at increased risk of cardiac death due to the increased risk of atrial arrhythmias and heart failure. Moreover, autoimmune hyperthyroidism has been linked to autoimmune cardiovascular involvement. Pulmonary arterial hypertension, myxomatous cardiac valve disease and autoimmune reversible and irreversible dilated cardiomyopathy have been reported in patients with Graves disease. Short-term hypothyroidism is characterized by a low cardiac output due to decreased heart rate and stroke volume. Subclinical hypothyroidism with TSH> 10 mU/L is an important risk factor for heart failure and coronary heart disease events and mortality in adults. Replacement doses of L-T4 may improve cardiovascular remodelling and function in patients with overt and subclinical hypothyroidism, and may improve the cardiovascular risk factors associated with mild hypothyroidism.

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What Treatments Will I Need

The overall goal is to get thyroid hormone levels back to normal. But since AFib raises your odds of having a stroke, the first step is to get your heart under control.

AFib treatment. To control your heart rate, you may get medicines like:

  • Beta-blockers, usually the first choice
  • Calcium channel blockers, if you can’t take beta-blockers
  • Digoxin, a more likely option if you also have heart failure

Depending on your overall health and how likely you are to have a stroke, you might also get drugs to lower your chances of a blood clot. Common options include anticoagulants such as warfarin , apixaban , dabigatran , and rivaroxaban .

Thyroid treatment. There are usually two steps here. You start with anti-thyroid drugs that prevent your thyroid from making too much hormone. You usually see improvement within 2 weeks.

These drugs help settle things down, but they’re not usually a long-term solution. For one thing, they may not work as well over time. And with continued use, they can have serious side effects, including liver damage.

That’s why the second step is often a treatment called thyroid ablation. You usually take one pill of radioactive iodine, which destroys your thyroid. After that you’ll need to take a daily thyroid replacement hormone.

For some people, removing the thyroid also prevents AFib.

An Overactive Thyroid And Your Heart

How Thyroid Dysfunction Affects Your Heart

If your thyroid is overactive, its producing too much hormone and your metabolism will be faster than normal. This condition is called hyperthyroidism. This can cause your heart to beat faster than normal, which can lead to:

  • Abnormal heart rhythms that could cause sudden cardiac death, according to a 2016 study reported by the American Heart Association
  • Atrial fibrillation , the most common and also the most dangerous heart risk associated with thyroid disorders
  • Heart palpitations
  • High blood pressure
  • Angina

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Deadly Connection: How Does Thyroid Disease Affect The Heart

Hypothyroidism often comes with heart issues. Thyroid problems have to be treated because heart complications that come with the disease can be quite serious. If someone has a weak heart, hypothyroidism can make the existing heart problem even worse. Hypothyroidism can even lead to developing new heart conditions in people with no history of coronary diseases.

The Thyroid Is A Small Gland But It Helps Coordinate Many Of Your Body’s Activities From Metabolism And Weight To Hair Thickness And Sweating

Maybe you’ve heard people say, “I’m tired because I have a thyroid problem.” Or, “I see an endocrinologist because I have thyroid issues.” But how much do you really know about your thyroid?

The thyroid is a small gland that is butterfly shaped and located at the base of the neck, just below the Adam’s apple. It’s part of the endocrine system, which helps coordinate many of your body’s activities. The gland makes hormones that regulate your metabolism. But when it’s not working right, your body can be affected in various ways.

You don’t produce enough hormone. Hypothyroidism is also known as Hashimoto’s disease or Hashimoto’s thyroiditis. It is most common in middle-aged women, but Hashimoto’s disease can happen at any age. Here, your immune system mistakenly attacks and slowly destroys the thyroid gland and its ability to make hormones. Treatment may include taking daily medication and monitoring the dosage to ensure you’re taking the right amount. Your doctor may pass on medication and take a wait-and-see-approach.

You produce too much hormone. Hyperthyroidism is also known as Graves’ disease. This autoimmune disorder happens when the body’s immune system mistakenly attacks the thyroid gland. It’s hereditary and is most common in women ages 20 to 30. Some treatments include radioactive iodine therapy , prescription antithyroid medications , beta blockers or surgery to remove all or part of your thyroid.

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A Cardiovascular Symptoms And Signs In Hyperthyroidism

Cardiac symptoms are common in hyperthyroid patients . One can distinguish between chronotropic alterations, which are manifested by sinus tachycardia, AF, and shortened PR intervals, and inotropic alterations, which reflect changes in the systolic contractile behavior of the heart . Alterations in the pulse and heart tones, as well as Means-Lerman scratch may also be observed in hyperthyroidism. In addition, rare reports of heart block in Graves disease should be mentioned .

How Does Underactive Thyroid Affect The Heart

Hashimoto’s, Hypothyroidism & The Heart: What You Need to Know

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