OBSERVATIONS OF THE CARDIOVASCULAR SYSTEM IN THYROID DISEASE

The importance of the cardiovascular signs and symptoms in thyroid disease has been known from the earliest writings on goiter. Parry,¹ in 1786, recognized the seriousness of these manifestations, his first case presenting grave cardiac disorders resulting in death. Since that time practically all authors have agreed thatthe outcome of any case is greatly influenced by the state of the circulation and its response to therapy. Möbius,² in 1896, emphasized the importance of tachycardia, palpitation, forceful beating of the heart and arrhythmia in the syndrome of thyrotoxicosis, and stated that exophthalmic goiter patients suffer and die mainly because of cardiac changes. Hirschfelder³ reviewed the subject and gave the prevailing opinions regarding the cardiovascular findings and their treatment. Forchheimer⁴ directed therapeutic measures in thyroid disease toward the support of the circulation. Kocher⁵ and others believed that the surgeon should be guided by the cardiac condition in choosing the time and extent