الفهرس 
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Abstract
The thyroid and the cardiovascular system are closely related in many ways, so any pathological condition affecting the thyroid affects the heart as well. The adverse consequences on the heart of overt hyper and hypothyroidism are well-known and even subclinical forms of both hyperthyroidism and hypothyroidism are associated with increased cardiovascular morbidity and mortality. Recently those forms of subclinical thyroid diseases gained more and more attention as they are often subtle and hard to be diagnosed. So, more work should be done towards detscting it‘s prevalence and to decide the need of screening for it and whether should it be treated or not.
As thyroid diseases have racial and environmental aspect, so that local studies should be done to detect it‘s prevalence.
In our study we included 200 IHD patients proved by previous positive coronary angiography, and we subjected them to clinical, ECG, Echocardiography, thyroid ultrasound, and laboratory evaluation to discover the prevalence of thyroid dysfunction among them and to discover the relationship between thyroid dysfunctions and the physical, laboratory, and radiological profile of the patients.
The result of the study showed that, the prevalence of thyroid function abnormalities among the study patients was 35 patients out of 200 having thyroid abnormalities(17.5%), of them 12 % (24 cases) with hypothyroidism (TSH more than 4.5 mU/l) of which the subclinical form represents 19 cases(9.5%) and 5 cases are of the overt form(2.5%) And 5.5% (11 cases) discovered to be hyperthyroid of them 6 are subclinical form (3%) and 5 are overt hyperthyroidism(2.5%).
In comparison with other studies that shows the prevalence in general population it was found that it is much more higher in ischemic patients, especially subclinical hypothyroidism. This should be taken into consideration when we search for the risk factors for IHD.
Our study showed that there is positive correlation between TSH and age, which may reflect early thyroid failure, and may indicate follow up for thyroid function.
We discovered also that there is significant increase in PASP in thyroid patients especially the hyper thyroid group.
Also our study showed that there is strong association between the presence of hypothyroidism (even the subclinical form) and dyslipidemia (increased LDL, TC, TGs and decreased HDL) which is considered a major risk factor for atherosclerosis and ischemia and may explain the increased incidence of IHD in clinical and subclinical hypothyroidism.
Hyperthyroidism was also found to be related to many hemodynamic alterations (increasd systolic BP, tachycardia) that may subject the heart to increased load and increased incidence of arrhythmias especially AF, which should drive attention to search for hyperthyroidism.
There was negative correlation between fT3 and the occurrence and severity of symptoms of heart failure with significantly increased incidence and severity of dyspnea, orthopnea and even congestive heart failure.