Apathetic Hyperthyroidism – Hyperthyroidism in the elderly

Diagnose apathetic hyperthyroidism:

  • In the elderly, hyperthyroidism (over activity of the thyroid gland – hypermetabolic state), may present with only depression, slow Afib, CHF, weakness, weight loss, and a small goiter.
    • A high index of suspicion is needed to make the diagnosis.
    • A masked hyperthyroidism, more common in depressed older patients – psychological withdrawal (depression, apathy)
    • Arrhythmias: Afib, supraventricular tachyarrhythmia (SVT))
  • A form of Graves’ disease that tends to affect mainly older adults who have stereotyped “senile” physical features and whose behavior is apathetic and inactive rather than hyperkinetic.
  • Medical treatment restores normal heart rhythm and behavioral activity.
  • Untreated, the patient is likely to succumb to the effects of stress or acute illness.

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