Heart Patients and High Heat and Humidity

Summer time is here! Most of us welcome the heat, however heart patients have to be cautious. When the heat and humidity rise so does the incidents of heart problems. If the heart muscle has limited blood flow to its heart walls, when the heat gets up there the heart’s blood flow can become compromised. As the blood goes to the skin to cool the body, it may limit the amount it can provide its own muscle.  Most importantly high humidity appears to increase the incidence of acute myocardial infarction (AMI) or heart attack leading to death among the elderly.

The American Heart Association warns people about the effects of hot weather on their health. Extreme heat can cause dehydration, heat exhaustion and stroke. Add in high humidity and you can find a very dangerous situation. Warn seniors to limit outside activity when the temperature is above 70 degrees with humidity above 70%. With these conditions, the body’s natural cooling mechanisms are affected.

During hot summer months, outdoor activity such as exercise walking and gardening should be limited to cooler times of day in the early morning or in the evening. Seniors should also be encouraged to increase their water intake to compensate for fluid lost in hot weather. The American Heart Association suggests monitoring your weight by weighing your self in the morning after using the restroom. If your weight is down by two pounds or more you should increase the amount of water you drink. Avoid fluids with caffeine as they can increase fluid loss. Even if you are dieting and weight loss is expected you still need to drink plenty of water to stay healthy.

Remember, dehydration can lead to heat exhaustion which can lead to heat stroke. Heat stroke can kill, especially if you are an older adult with a health condition.

The symptoms of heat exhaustion include:

• excessive heavy sweating
• cold clammy skin
• feeling dizzy or fainting
• rapid weak pulse
• muscle cramping
• rapid shallow breathing
• vomiting, nausea or both

I can’t emphasize enough the importance weighing self daily and listening to the bodies symptoms. Many patients who are predisposed to congestive heart failure do not tolerate the heat and humidity. By weighing yourself daily you can identify if there is a sudden spike in the weight. If you are holding fluid this is not the time to be physically active. If your weight is up 3-5 lbs do not exercise. Do not get into the habit of thinking that you should simply exercise more to take off the excess weight. Get into the habit of asking yourself does the weight mean I am holding fluid? Suspect fluid if your blood pressure is elevated, you notice increased swelling in legs, or belly, if you are more short of breath, or activity feels more strenuous. Avoid salty meals when the heat is on. Increased sodium intake makes you hold more fluid in the blood stream and with congestive heart failure that fluid backs up in the cardiovascular system working the heart extra hard. Stick to the fresh fruits and veggies, and a lemon aid.

When  patients come to exercise but are fatigued from the heat already, they shouldn’t exercise. I send them home or let them visit and enjoy the air conditioning.  No big deal if you miss a week or two due to a hot spell. You will get back to it. It is better to be safe than spend summer in the hospital or worse.

Keep in mind the air quality also gets worse when the heat and humidity are on. Poor air quality, air pollution is a known risk for increased heart attacks. If  you live in an area with lots of smog or pollution in the air, avoid doing strenuous activity outdoors as now you the additional risk added to the heat issues.

• Exercise when the heat has broken or exercise very lightly in air conditioning.
•  Try a slow walk or a light bike in a cool environment.
• Cut your intensity and duration in half.
• Drink your water.
• Don’t overdress. I always laugh when on the hottest days people show up to exercise in their sweat suits.
•  Get in the water and exercise or just walk in the water.
• Practice relaxation and meditation instead of strenuous exercise.
• Eat fruits and vegetables for potassium and magnesium.
• Consider electrolyte replacement.
• Cold wet washclothes at the pulse points – wrists, neck or forehead to cool the body