Cardiovascular and Adrenergic Manifestations of Cold Stress

Ischemic cardiac morbidity is the most common cause of death in the United States in patients undergoing surgery as well as in the non-perioperative setting.(l). Coronary artery disease is ultimately the predisposing factor in patients who suffer cardiac death, but usually a triggering event disrupts the delicate balance between myocardial oxygen supply and demand and leads to ischemia and infarction. Some of the factors that have been shown to induce myocardial ischemia include tachycardia, hypertension, hypotension, thrombosis, and cold stress. Bainton et al. (2) described a two-fold increase in the death rate from ischemic cardiac events in the winter relative to the summer. This study was a simple epidemiologic description of the relationship between time of year, ambient outdoor temperature, and mortality. These results have been confirmed by other investigators as well.(3) Neither study, however, has determined, or even proposed a mechanism to explain the higher death rate.KeywordsMyocardial IschemiaCold StressCore TemperatureCold Pressor TestPeripheral VasoconstrictionThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.