How does thyroid problems affect heart palpitations?
Thyroid gland is located in the neck, just below the Adam’s apple. It produces T3 and T4 hormones, which are responsible for many vital functions. Some of thyroid hormones functions are as following:
1. On the metabolism
They increase basal metabolism. T3 and T4 stimulate fat and carbohydrate metabolism.
2.Growth
Thyroid hormones are necessary for a normal growth of the children.
3. Developement
Normal levels of T3 and T4 are necessary for an normal development of fetal and neonatal brain.
4. Cardiovascular system
Thyroid hormones increase cardiac rate, cardiac contraction and cardiac output.
5. Nervous system
Altered levels of thyroid hormones affect mental state.
One of the main causes of heart palpitations is hyperthyroidism, which increased production of T3 and T4. No matter what the cause of hyperthyroidism is (tumors, inflammation, autoimmune diseases, strumas etc) its effect on heart is the same: overstimulation of the heart muscle causing increase of heart rate, heart contractility and heart output.
So, the heart beats faster, stronger and due to this, it pumps more blood per minute than it normally pumps. All this effects are perceived by the patient as awareness of the heart beating, so palpitations.
What is the treatment strategy?
The treatment of thyroid heart palpitation is the treatment of hyperthyroidism itself.
There are some strategies available in treating hyperthyroidism, depending on the reason causing it.
1. Antithyroid medications – this are medications that prevent the thyroid gland to produce hormones. Propiluracile and Methimasole are the most used medications. Heart palpitations will subside after 2-3 months, but the intake of medications will continue for more than one year.
2. Beta blockers – are medications that keep the palpitations under control, by blocking specific parts in the cell where the thyroid hormone operates.
3. Radioactive Iodine – It is a medicament that contains radioactive marked iodine. Captured and accumulated by the thyroid gland cells, this substance destroys thyroid tissue by emitting radioactive rays. Permanent hormonal therapy replacement will be needed afterwards, because this technique causes the permanent destruction of thyroid tissue.
4. Surgery – the surgeon omits all the thyroid gland(total thyroidectomy) or only the part of it that overproduces hormones. Permanent hormone therapy replacement will be needed after surgery.
Whichever the chosen therapeutic solution, it will subside all the effects of hyperthyroidism, and heart palpitations among other symptoms.
What other health problems to consider?
Thyroid heart palpitations are due to the stimulation of the heart by thyroid hormones. Having thyroid heart palpitations does not mean that there is an underlying heart disease present. However, the overstimulation of heart muscle , for a long time ,may cause an incoordination of the conduction of the electrical impulses within the heart, which can lead in atrial fibrillation.
Also, the prolonged contraction of the heat muscle can lead to an increase in the blood pressure which is called systolic hypertension.
If hyperthyroidism is not treated in a long period of time, it will cause cardiac insufficiency, an irreversible disease of the heart which leads to heart failure.
When having heart palpitations, the doctor has to rule out other causes that cause this condition such as caffeine or heart diseases.
Heart diseases are diagnosed by some tests (EKG, Holter, cardiac-ECHO, stress-test etc).
The diagnose of hyperthyroidism is made by making a TSH evaluation in the blood : Decreased levels of TSH and increased levels of T3 and T4 are signs of hyperthyroidism.
After the diagnose is clear, the treatment has to initiate immediately, to permanent heart complications.