Cardiac Health in Summer
Temperature rise is one of those conditions, which leads to illness and death that come up depending on weather conditions. Heat can cause exhaustion, heat stroke, cardiovascular disease and respiratory disease. Hot weather does not pose equal effect on everyone. Patients with heart disease and other chronic disease, children and elders, athletes and those who have mental illness are more prone to consequences of hot weather.
There is also an apparent temperature, which is related with air humidity, along with air temperature that is measured in the outdoor. Air humidity correlates positively with apparent temperature. If outdoor temperature changes, some of the heat regulation mechanisms in our body get activated and prevents the variation of body temperature. Body loses heat with sweating and evaporation of sweat. Dilatation of subcutaneous blood vessels increases blood circulation in the skin, resulting with the reduction of body temperature. This condition leads to low blood pressure and increase in pulse rate. The workload of the heart that pumps blood to subcutaneous vessels to balance the body heat increases and heart works rapidly.
Heart failure means that heart cannot pump enough blood to body organs. Heart disease and diabetes lead to heart failure. Those patients are managed with medications, specific therapies lifestyle modifications. In hot weather, symptoms of heart failure get heavier. Hot weather may result with heart attacks and other heart diseases. Hot weather increases body’s heat stress, and physiological responses, which are related with cellular damage and inflammation, are stimulated, which further worsen heart failure.
There is no increase in heart rate due to heart disease or secondary to medicines such as beta blocker in patients with heart failure, and this condition has negative influence on heat loss from the body. Diuretic agents may easily lead to dehydration. However, heart failure may deepen, if patients with heart failure drink extra water in hot weather. Heat stroke will be more likely, if hypertensive patients consume less salt. Dehydration that occurs due to high blood glucose levels in diabetics can prevent normal sweating mechanism of the body. Many patients do not recognize dehydration and do not drink water. Cooling mechanism of body does not properly function in obese patients, and thus, obesity brings an additional burden for the heart. Irritants and allergens in the hot and humid weather are not good for asthmatic patients. Some medications which are used in the treatment of asthma can prevent the body’s reaction to heat.
Mild illness status caused by high weather temperature is the heat exhaustion. It depends on the loss of water through sweating and salt. Headache, extreme sweating, cold and clammy skin, shaking, dizziness, sense of fainting, weak and rapid pulse, muscle cramps, rapid and superficial breathing, nausea and vomiting occur. It is seen in people who have a heavy/strenuous work or exercises in hot weather. In this case, the patient should be transferred to a cool or shadow place; his/her clothes should be taken off and allowed to rest until the complaints disappear. A cold shower can be taken. Efforts are made to have patient drink plenty of water. Alcohol, caffeine and sweat drinks that cause dehydration are avoided. If the complaints persist > 1 hour, patient should be transferred to a hospital. The heat stroke is a serious condition; body temperature rises above 39 Celsius degrees, and the skin is dry, hot and red. There is throbbing headache. Pulse is above normal limits; nausea, dizziness and altered mental status are observed. Vomiting and involuntary movements can be seen. Patient should be transferred to a cool place, body cooling techniques, - such as ice compression or wet clots-, should be used and must be immediately taken to the hospital.
How should we live in the summer?
*To reduce negative influences of hot weather, drink more water and avoid alcohol and caffeine beverages. Drink plenty of water before, during and after activities to avoid dehydration.
*To avoid from sunlight, use broad-brimmed hats, sunglasses and protective sun creams. Avoid extreme activities at the noon when the sunlight exposure is strong.
*Wear light, thin, light-colored clothes, and prefer breathable cotton fabrics. It is the evaporation of sweat, rather than sweating, that lowers the body temperature, and therefore, you should wear thin clothes. Prefer comfortable shoes and socks; aerate your feet and use foot care powders and antiperspirants.
*In the summer, you should do exercises in morning or at night, when sunlight exposure is minimal. In the high temperature and humidity conditions, intensity and duration of exercise should be reduced. To get used to the hot weather, you can gradually increase time of stay outdoor. For regular physical activity, you should do exercises indoor. Doing exercise with a friend or a relative is always safer and more fun.
*If you have a heart disease, you are older than 50 or you are overweight, you should take some special precautions for hot weather by consulting to your doctor. Some heart medications such as beta blockers, ACE inhibitors, diuretics and calcium channel blockers may modify metabolic reaction to heat. Tranquilizers and anticholinergics are the medications that increase risk of heat stroke. Elder people should be always careful, even if they do not take medicine. You may be not aware that you are thirsty when you are over 50, but you should better drink water, even if your do not feel thirst.
Precautions to be taken at home
You do not go out from 11.00 to 15.00 – the hottest interval of the
You can do daily work in early morning before temperature rises. In order to minimize outdoor activities at hot weather, supply your needs – such as medicines, food and drinks- beforehand, and store copious amount of water at home; strictly avoid high-calorie heavy foods.
Have the ice in the freezer.
Check the ventilation of the house.
Do not unnecessarily open windows; hang light curtains to cover windows with high sun exposure. Dark curtains absorb heat and increase temperature of your room.
Sit in an air conditioned room at south or east part of your house. Have air conditioners maintained and checked.
You can also spend your day in cool places such as shopping center, library and cinema. Be informed about weather conditions; check the weather conditions of the place if you have travel plans.
We wish you a healthy summer…
Do you know those?
*In the air-conditioned environment, air temperature should not be reduced below 25 degrees.
*High land tourism above 2000 m of altitude is not good for cardiac health of patient. They should live at a lower altitude.
*Shower should not be taken with ice-cold water for cooling and rather, it should be taken with mild water.
*Hot weather may cause depression.
* People who made exercise regularly should not stop activities in the warm summer; 4 to 6 weeks of inactivity eliminate beneficial effects of exercise.
* Sense of thirst is not a reliable indicator of water ingestion requirement. If urine color is light and clean, it implies hydration is good, but if the color is dark, dehydration should be taken into consideration. Even if you sit in a hot and humid air without doing exercise, you may still need water.