My cat got hyperthyroidism when she was 16, and she also had a heart murmur. We used medication, but our vet upped the meds when they should have been reduced. This caused our cat to go into heart failure, and she died a couple of weeks later. If you use meds, use a very small dose, and increase in small increments. I regret so much that I didn't know more about this condition and how it should be treated and instead took her to a vet where she saw a different dr every single time we went. Now, I've found a wonderful vet, and I always just see her.