The racing heart that is characteristic of thyrotoxicosis can complicate preexisting heart disease, or worsen risk factors that predispose you to heart disease, even in the absence of Graves' disease. If you have any of these conditions while thyrotoxic, you need to take steps to lower some of these other risk factors as soon as possible. In addition, heart rhythm problems can be induced by thyrotoxicosis in Graves' disease. While most young people with otherwise normal hearts have rapid regular heartbeats (called sinus tachycardia), older people or those with some heart problems may have an irregular rapid heart rhythm called atrial fibrillation. Atrial fibrillation requires the intervention of a cardiologist, particularly since it can cause blood clots that result in strokes. Thy-
rotoxicosis is also a risk for these clots, and if it results in atrial fibrillation, blood thinners are usually necessary. (See Chapter 25 for more on heart complications.)
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