Elderly non-typical manifestation of hyperthyroidism

Hyperthyroidism is a common disease of the endocrine system, for a career in medicine for more than 40 years, doctors, a diagnosis of hyperthyroidism no difficulty, but the elderly diagnosis of hyperthyroidism sometimes is not easy. I recently had a first-hand experience of the elderly is not typical manifestation of hyperthyroidism. More than three months ago inductance chest tightness, on the stairs, obviously shortness of breath, heart adequate running before District myocardial hypoxia and there is a narrow sense, forced to cease their activities to relieve symptoms, but before the pain and unmotivated Paroxysmal palpitation, emotional and exciting indifferent, diarrhea, Pare, loss of appetite and wasting, and other symptoms of hyperthyroidism, the body temperature and blood pressure normal, no widened pulse pressure, no exophthalmos and goiter, vascular murmur negative, not heart sector, heart rate of 74 beats / min, the law will, no noise, no hands tremor, Holter except for a little premature beat, no significant myocardial ischemia objective basis. Although normal ECG, but by age and clinical performance, first consider coronary heart disease is understandable that, after a period of treatment not improved, baffling. I carefully pondering, the heart rate in the usually quiet state of the state is generally more sinus relief, 56 beats / min or so, according to past Holter recording, the slowest night of heart rate was 48 beats / min, but in more recent heart rate of 74 beats / min around , the night also the slowest heart rate of 60 beats / min after onset heart rate increased slightly, though still in the normal range, but it is also a noteworthy clues to the diagnosis, with clues that the signs, I take the feelings of blood test Measurement of thyroid function, the results FT3, FT4 were significantly higher TSH reduced to 0, diagnosed as hyperthyroidism, I feel relieved by the drug therapy after symptoms disappear. Hyperthyroidism majority of the elderly is not typical clinical manifestations, exophthalmos and a swollen, and other signs are not obvious and more often to the first symptoms of arrhythmia diagnosis and misdiagnosis rate can be as high as 71.4%. Experienced doctors on the exact cause of the arrhythmia, spirit weak, emaciated and so will be measured by conventional thyroid function, hyperthyroidism confirmed or ruled out, but chest tightness, shortness of breath for the main symptoms and no signs of the cardiovascular system, such as atrial fibrillation, Heart rate in the normal range, even without a sudden swollen eyes of the elderly, such as hyperthyroidism is rare. Thus when elderly patients with coronary heart disease have like symptoms, and should be done Holter ECG, pay attention to changes in heart rate, as far as possible, past data and the control to see whether there are increasing faster heart rate, especially at night heart rate, which is very important, when necessary, thyroid function tests done so bungled hyperthyroidism or hyperthyroidism with coronary heart disease treatment.