Chest Pain and Thyroid

Q: I am an African-American female, 43, who is overweight and gets little exercise. I also have hypothyroidism. Tests show nothing wrong. Yet I have a slightly irregular heartbeat and at times suffer from what feels like angina. What should I do?

A: Recent studies have demonstrated that there is an association with hypothyroidism and heart disease in women. However, it is important that if you are taking hypothyroid replacement medication that you check your thyroid levels every six to 12 months. Elevated levels of thyroid hormone can produce symptoms of shortness of breath and a fast or irregular heart rate.

Your doctor might suggest a stress cardiac imaging study (exercise echocardiogram or a nuclear stress test) to evaluate for coronary artery disease. An exercise test will also show evidence of exercise-induced irregular heart rhythms, which can be associated with abnormal thyroid levels or coronary artery disease. Stop exercising until you have consulted your doctor.

Jennifer H. Mieres, M.D., is director of nuclear cardiology and associate professor of clinical medicine at New York University. She’s also a spokesperson for the American Heart Association.