What cardiovascular symptoms are associated with hypothyroidism?

• A. Bradycardia, hypotension, enlarged heart
• B. Tachycardia, hypertension, small heart
• C. Normal pulse with high blood pressure
• D. Irregular heartbeat only

Answer: (A)

When thyroid function drops, the body's overall metabolic drive slows down. That means the heart doesn’t need to beat as fast, and the heart’s pumping efficiency often decreases. A slower resting heart rate (bradycardia) is a common finding. With reduced cardiac output, blood pressure can fall (hypotension). In more prolonged or severe hypothyroidism, the heart can become enlarged on exam or imaging, partly due to fluid around the heart and other changes in the heart muscle, so cardiomegaly can be seen.

So the combination of a slow heart rate, lower blood pressure, and an enlarged heart fits the cardiovascular changes you expect in hypothyroidism. Patterns like a fast heart rate with high blood pressure point toward hyperthyroidism, a normal pulse with high pressure doesn’t match the reduced cardiac output, and an irregular heartbeat alone doesn’t capture the typical triad you’d expect.