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Suggest Treatment For Swelling Of Legs When Diagnosed With Graves Disease
Question: I have graves disease and recent leg swelling. I am taking beta blockers but heart rate is still at 100. Have not seen endocrinologyyet at er last night heart enzyme went from 14 to 253 what should i do. Have ulftssound next week and seeing nuclearmed the following week
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
I understand your concern and would like to explain that Graves' disease is not rarely associated with cardiomyopathy.
Because the overproduction of thyroid hormones leads to overreaction of circulating catecholamines, which left unopposed for a long-standing period causes cardiac arrhythmic and cardiac dysfunction (heart failure), your racing heart rate, leg swelling and increasing cardiac enzymes are quite understandable in this setting.
The optimal strategy to stop and possibly reverse this situation is starting an adequate etiological antithyroid therapy, quantifying your possible cardiac dysfunction by cardiac ultrasound and investigating for possible cardiac arrhythmia by Holter monitoring (ambulatory ECG monitoring).
Probably at the beginning you will need a concomitant heart failure therapy. This will depend by your cardiac performance status and the persistence of heart failure symptomatology.
I would be glad to review your medical tests when they are concluded, and give my professional opinion on possible cardiac implication and therapy.
Meanwhile I recommend you to test:
- an actual thyroid hormones level
- blood electrolytes
- BUN and creatinine levels
- repeated cardiac enzymes level,
- perform a resting ECG to exclude any possible cardiac arrhythmia (most frequent atrial fibrillation) or ischemic changes.
In case cardiac enzymes continue their increase, you should immediately consult with your cardiologist for an urgent cardiac ultrasound.
Hope to have been of help!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
I understand your concern and would like to explain that Graves' disease is not rarely associated with cardiomyopathy.
Because the overproduction of thyroid hormones leads to overreaction of circulating catecholamines, which left unopposed for a long-standing period causes cardiac arrhythmic and cardiac dysfunction (heart failure), your racing heart rate, leg swelling and increasing cardiac enzymes are quite understandable in this setting.
The optimal strategy to stop and possibly reverse this situation is starting an adequate etiological antithyroid therapy, quantifying your possible cardiac dysfunction by cardiac ultrasound and investigating for possible cardiac arrhythmia by Holter monitoring (ambulatory ECG monitoring).
Probably at the beginning you will need a concomitant heart failure therapy. This will depend by your cardiac performance status and the persistence of heart failure symptomatology.
I would be glad to review your medical tests when they are concluded, and give my professional opinion on possible cardiac implication and therapy.
Meanwhile I recommend you to test:
- an actual thyroid hormones level
- blood electrolytes
- BUN and creatinine levels
- repeated cardiac enzymes level,
- perform a resting ECG to exclude any possible cardiac arrhythmia (most frequent atrial fibrillation) or ischemic changes.
In case cardiac enzymes continue their increase, you should immediately consult with your cardiologist for an urgent cardiac ultrasound.
Hope to have been of help!
Kind regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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