Endocrine Heart Disease

With the increasing prevalence of obesity and diabetes mellitus in the United States, associated cardiovascular disease is reaching epidemic proportions with staggering economic and societal impact. Numerous studies have demonstrated the poorer prognosis associated with chronic coronary artery disease and acute coronary syndromes in patients with diabetes compared with nondiabetic patients. Although the therapeutic strategy is largely the same for the two populations, proper management of the diabetic patient with cardiovascular disease must account for the associated metabolic disturbances. Thyroid disease is the next most common endocrine disorder that affects proper function of cardiovascular patients; all patients presenting with coronary artery disease or cardiac arrhythmias should undergo screening with a sensitive thyroid-stimulating hormone assay and appropriate treatment when necessary. Though these areas are the most common points of intersection between the cardiologist and endocrinologist, a thorough understanding of the impacts of each endocrine system on cardiac function is essential to recognize disease entities that often present with a cardiovascular manifestation or affect patients with a primary cardiovascular disease.