<s>[INST] Hi, may I answer your health queries right now ?  Please type your query here... I have had ongoing chest pressure and SOB.  Recent CXR showed moderately enlarged heart and R atrium. Have a h/o of hypothyroidsm, currently not at theraputic level abd started BCP last month at age 36.  Could either of these have cause the heart problems? If not what could be the reason?BP is fine. [/INST] Hello Thanks for posting at Chat Doctor. Hypothyroidism can cause heart rate abnormalities like irregular fast heart rate. Irregular fast heart rate can lead to symptoms like palpitations, fatigue, breathlessness. Chest pressure is unlikely, but palpitations can be misinterpreted as chest pressure. Since your Chest x-ray shows heart enlargement, you mist get evaluated for the same. Please do am ECG which will document of there are any heart rate abnormalities, and a 2 d echo which will show whether the heart is enlarged and which chambers are enlarged. It will also show if there is any leak between the heart valves and the pumping function of the heart. Please do the above tests and revert. Meanwhile, please start taking your hypothyroidism tablets. Wishing you good healthRegards </s>