In my previous blog, I discussed how hyperthyroidism can affect the heart. When I refer to the heart, I always focus on the major components that need to be addressed. They include the actual strength of the muscle, blood flow, heart valves and the heart's electrical system. Once these are understood, we can delve into the issues that people may have with their heart especially as it relates to thyroid issues. Hypothyroidism is a term referred to low thyroid hormone production. Many different disease processes may cause this type of abnormality. Common systemic symptoms include: 1. Fatigue, tiredness, weakness; 2. Dry skin; 3. Hair loss; 4. Difficulty with memory and concentrating; 5. Constipation; 6. Weight gain with poor appetite; 7. Shortness of breath; 8. Hoarse voice; 9. Excessively heavy menstrual cycles (later reduced menstrual bleeding or no menstrual cycles); 10. Impaired hearing Again we will focus on the heart through the above model: 1. Heart muscle: Heart muscle weakness is uncommon with this disorder; 2. Blood flow to the muscle: Patients with low thyroid hormone levels tend to have high levels of cholesterol which may produce heart artery blockages, thereby reducing the blood flow to the heart muscle; 3. Heart valves: This disorder rarely affects the heart valves; 4. Heart’s electrical system: This disorder typically produces a weakened pulse rate, and slow heart rates (less than 60 beats per minute). In addition on the electrocardiogram (EKG,ECG) there are a number of changes that may be seen, including low waveforms, slow heart rates; 5. Other heart related changes that can occur with low thyroid levels include: fluid build up around organs in including the heart and lungs. When fluid builds up around the heart it is referred to as pericardial effusion. This can compromise the heart’s ability to effectively pump even though the muscle is strong. Luckily, this is usually occurs only with a long standing untreated hypothyroidism.