✔ Sweating in cardiovascular diseases
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Sweating in cardiovascular disease: physiological basis and clinical relevance
Sweating (Sudoratio) is an important mechanism of Thermoregulation in the human body. In patients with cardiovascular disease, the sweat production can occur, however, in contrast and as a symptomatic or diagnostic feature of importance.
Physiological bases of sweating
The sweat glands are controlled by the autonomic nervous system, especially the parasympathetic and sympathetic division. The sympathetic branch plays in the thermo-regulatory sweat secretion, the main role: Under the action of acetylcholine activated glands ekrinischen welding, for the discharge of aqueous sweat responsible.
During physical exertion, or increase in the body temperature, sweat production increases in order to keep due to evaporation, the body temperature of cold-stable. This process requires an intact blood supply to the skin, and an adequate fluid intake.
Sweating in the context of cardiovascular diseases
Certain cardiovascular diseases can affect the welding reaction:
Congestive heart failure. In patients with chronic heart failure, it can lead to a change in the welding reaction. The decreased pumping function of the heart leads to a reduced Perfusion of the peripheral tissues, including the skin. This can affect the thermo-regulatory perspiration and lead to insufficient cooling under load. In addition, the activation of the sympathetic nervous system can lead as a compensation mechanism for excessive sweating (hyperhidrosis), and in particular in the case of effort.
Hypertension. In hypertension, the increased activity of the sympathetic nervous system can also lead to increased sweating, especially in stressful situations or in case of medication side effects (e.g., calcium channel blockers, or nitrates).
Cardiac Arrhythmias. Sudden sweating (cold welding) are not in the case of arrhythmic events, such as atrial fibrillation or ventricular fibrillation rare. They often go together with anxiety, tachycardia, and shortness of breath, and are part of the adrenergic stress response.
Acute coronary syndrome (e.g., myocardial infarction). One of the typical symptoms of a heart attack, a sudden, cold sweat, which is often accompanied by severe chest pain, Nausea, and dizziness. This reaction is triggered by the massive activation of the sympathetic system and the release of stress hormones (adrenaline, noradrenaline).
Orthostatic Hypotension. Patients with orthostatic Dysregulation (e.g., due to the autonomy of neuropathy in Diabetes) can sweat it out when you get Up strongly, while at the same time, the blood pressure drops. Here is a disturbed autonomic Regulation plays a Central role.
Diagnostic and clinical significance
An unusual sweating behavior — in particular, sudden, strong, or cold-induced sweating without obvious cause should be taken in patients with known or suspected cardiovascular disease and serious. It can be an indication of an acute cardiovascular decompensation and requires fast evaluation (ECG, blood pressure measurement, laboratory parameters, such as Troponin).
In addition, the investigation of autonomic function, including the welding reaction (e.g., with the help of Quantitative sudomotor of axonreflex tests, QSART), can contribute to the assessment of autonomic neuropathy in chronic cardiovascular diseases.
Conclusion
Sweating is not only a physiological thermal regulation mechanism, but can occur in heart disease‑circulation‑also as a clinical Symptom of great importance. The attention of welding patterns, especially of sudden, strong or atypical sweating can contribute to the early detection and treatment of life-threatening conditions. A differentiated clarification, taking into account the cardiovascular medical history is therefore of crucial importance.
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