Abstract
Thyroid hormones significantly affect the cardiovascular system. Untreated overt and subclinical hyperthyroidism are associated with a significant cardiovascular risk, mainly in the elderly.
Therefore, in patients with heart disease, subclinical hyperthyroidism is treated more often than subclinical hypothyroidism, provided that the hyperthyroidism is persistent and non-thyroidal suppression of TSH caused by low T3 syndrome is excluded. The effective and safe treatment of amio-darone-induced hyperthyroidism is preconditioned by distinguishing between type 1 and type 2.
Type 1 should be treated with methimazole or perchlorate with a prolonged therapeutic response, while type 2 is treated with glucocorticoids, with a faster response to therapy and more frequent permanent remission or development of hypothyroidism. Continuing with amiodarone is recommended in life-threatening arrhythmias, or in critically ill patients.
In other cases, the decision about continuing/withdrawing amiodarone is made on an individual basis. Close cooperation between the cardiologists and endocrinologist is essential.