Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Thank you for asking on HCM!

I understand your concern and would explain that a few premature cardiac beats are not considered a serious disorder when no associated cardiomyopathy is present.

As you have a history of hypertension it is important to investigate if any left ventricular hypertrophy is present, as a result of long standing uncontrolled high blood pressure.

Please could you upload your cardiac ultrasound report for me to review?

What about the left atrial dimensions? Is it enlarged?

If no hypertrophic cardiomyopathy, no important valvular disorders or left atrial enlargement, no obvious ischemic cardiac disease are present, then there is not any intrinsic cardiac disorders responsible for your scarce ectopic beats.

In such case, your chronic thyroid dysfunction remains one of the most possible triggering factors for generating those extra systoles.

Other potential extra cardiac factors may influence your heart rhythm as well, such as: GERD, possible chronic pulmonary disorder, or renal dysfunction (with underlying hydroelectrolytic imbalance), etc..

Coming to this point I would recommend performing the thyroid function tests, a blood lab tests and a cardiac ultrasound (if you haven't performed any recently) and if you have experienced chest pain symptomatology, I would recommend undergo a cardiac stress test.

Please could you upload your cardiac ultrasound and your rhythm recordings reports or any other performed tests?

Coming to the end I would like to assure you that a few ectopic beats are not considered a real disease, when no obvious cardiac disorders are present.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Greetings!

Dr. Iliri

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Brief Answer:
Opinion as follows:

Detailed Answer:

Hello again,

As you have performed several tests already, I would recommend to consider two main issues:

(1) A review of actual thyroid function (thyroid hormone levels testing) to assure if a suboptimal therapy needs to be readjusted. You need to discuss with your attending endocrinologist or internist about this issue.

(2) Exploring the cause(s) of ankles & feet swelling. First a careful physical examination for investigating possible systemic congestion, coupled with a new cardiac ultrasound is necessary to exclude a cardio-pulmonary implication on such clinical findings.

If no sufficient evidence is found, then other investigation would comprise lower limb vein insufficiency or hypoalbuminemia.

You need to discuss with your attending physician on the above options.

Regards,

Dr. Iliri

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