How should hyperthyroidism heart disease be examined?

Hyperthyroid heart disease refers to a condition in which the hormones secreted by the thyroid gland, which affect the heart and cause a heart attack, when the thyroid gland is overactive. It should be noted that the mortality rate of hyperthyroid heart disease is relatively high. The main causes of hyperthyroid heart disease are arrhythmia, rapid heartbeat, ventricular enlargement, heart failure and angina pectoris. How should hyperthyroid heart disease be examined and how can its attack be avoided? Let’s learn together.

1. Inspection method

1. Thyroid 131 iodine absorption rate test: 131 iodine absorption peak moves forward, rises or the curve rises rapidly.

2. Determination of thyroid hormones: serum T3, T4, FT3, FT4, etc. increased, and TSH decreased.

3.X-ray examination: The pulmonary artery arch is prominent and the cardiac shadow is enlarged.

4. Electrocardiogram

(1) Left ventricular hypertrophy.

(2) ST-T changes: pathological decrease in ST-T and T wave changes (depression, bidirectionality, inversion).

(3) Hyperthyroidism P wave: 26.2% of patients with hyperthyroidism have P wave changes in their electrocardiogram.

(4) Changes in PQ interval: The PQ interval is prolonged in 1.7% to 4.6% of patients with hyperthyroidism.

(5) High T wave: High T wave occurs in only 14% of patients with severe hyperthyroidism.

(6) QT interval: QT interval prolongation is more common than shortening.

2. Treatment Methods

1. Drug treatment

Commonly used drugs include methimazole (thimazole), propylthiouracil, and methylthiouracil, and one of them is generally selected. Such as methimazole (thimazole) 30-45 mg/d, methylthiouracil or propylthiouracil 300-600 mg/d. During treatment, the drug dosage should be adjusted appropriately according to the symptoms of hyperthyroidism. Once the symptoms of hyperthyroidism are controlled, the effective dose can be changed to an appropriate maintenance dose.

2. Radioactive iodine therapy

The general principle is that for hyperthyroid heart disease, especially hyperthyroidism accompanied by organic heart disease, in order to prevent recurrence, radioactive iodine treatment is recommended; for elderly patients, when antithyroid drug treatment is ineffective or the condition is severe, iodine treatment can be used; for patients who have undergone thyroidectomy once or several times and have recurred hyperthyroidism, iodine treatment is more appropriate. However, it should not be used by younger patients, especially those under 20 years old, pregnant women or those who may have thyroid cancer. The specific method is: first use antithyroid drugs for treatment, wait until the symptoms of hyperthyroidism are alleviated and the heart function is basically restored, stop the drug for 4 to 7 days, give radioactive iodine treatment, and add small doses of antithyroid drugs such as methimazole (thimazole) 15 to 30 mg/d as appropriate after 2 weeks, and maintain for 6 to 12 months. It should be pointed out that after one oral administration of iodine, it should not be repeated within 6 to 8 weeks.