MEDizzy - A 19-year-old woman presents to the clinic for evaluation of

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BASIC ENDOCRINOLOGY II

A 19-year-old woman presents to the clinic for evaluation of symptoms of weight loss, tremor, and heat intolerance. Her past medical history is negative and her only medication is the oral contraceptive pill. On physical examination, the blood pressure is 96/64 mm Hg, heart rate 110/min, and the thyroid exam reveals an enlarged non-tender gland with no nodules. The heart and lungs are normal but the skin feels warm to touch, and she has a fine tremor of her hands. Laboratory investigations reveal a low TSH and elevated free T4 and T3 levels. Which of the following cardiac findings is most likely to occur in her?

Explanation (B) Sinus tachycardia is the most common cardiac manifestation in a young individual with hyperthyroidism. Atrial fibrillation and cardiomegaly are common cardiac manifestations, but are more common in the elderly. Other symptoms include palpitations, tachycardia, nervousness, sweating, and dyspnea. Pericardial effusions are not typical findings in hyperthyroidism, and cardiac dilation may occur but only in severe prolonged hyperthyroidism that is untreated resulting in a cardiomyopathy.