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(Circulation. 2007;116:1725-1735.)
© 2007 American Heart Association, Inc.

Cardiovascular Involvement in General Medical Conditions

Thyroid Disease and the Heart

Irwin Klein, MD; Sara Danzi, PhD

From the Department of Medicine and the Feinstein Institute for Medical Research (I.K., S.D.), North Shore University Hospital, Manhasset, and the Departments of Medicine (I.K., S.D.) and Cell Biology (I.K.), New York University School of Medicine, New York, NY.

Correspondence to Dr Irwin Klein, North Shore University Hospital, 350 Community Dr, Manhasset, NY 11030. E-mail iklein{at}nshs.edu

The cardiovascular signs and symptoms of thyroid disease are some of the most profound and clinically relevant findings that accompany both hyperthyroidism and hypothyroidism. On the basis of the understanding of the cellular mechanisms of thyroid hormone action on the heart and cardiovascular system, it is possible to explain the changes in cardiac output, cardiac contractility, blood pressure, vascular resistance, and rhythm disturbances that result from thyroid dysfunction. The importance of the recognition of the effects of thyroid disease on the heart also derives from the observation that restoration of normal thyroid function most often reverses the abnormal cardiovascular hemodynamics. In the present review, we discuss the appropriate thyroid function tests to establish a suspected diagnosis as well as the treatment modalities necessary to restore patients to a euthyroid state. We also review the alterations in thyroid hormone metabolism that accompany chronic congestive heart failure and the approach to the management of patients with amiodarone-induced alterations in thyroid function tests.

Key Words: hyperthyroidism • hypothyroidism • heart failure • tachyarrhythmias • thyroid

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