The effects of moderate heat stress on patients with ischemic heart disease

With the use of a climate chamber, the effects of a 3-h exposure to moderate heat stress (23 to 29 degrees C) on the physiology, comfort, and performance of 20 subjects, 10 with slight (group I) and 10 with moderate (group II) ischemic heart disease (IHD), were studied. Twenty matched control subjects were similarly exposed. All of the subjects performed sedentary, mental work throughout the exposure. Humidity was 9 mm Hg; air velocity, 10+/-3 cm per second; and thermal resistance of the clothing, 0.7 clo. Under identical conditions no significant differences in rectal, skin, and finger temperatures or weight loss existed between the three groups, but during heat stress the temperatures and weight loss were always significantly higher than under the control conditions, except for rectal temperatures during the first 2 h. There was no difference between the groups or the two sets of conditions in respiration rate and diastolic blood pressure, but the patients had a significantly lower systolic blood pressure in the third hour of heat stress than under the control conditions. Heart rate and the rate-pressure-product during heat stress were significantly higher in the controls than in the patients. A few patients experienced a slight retrosternal oppression during heat stress, but only one had ECG changes, and none of these symptoms or signs were present under control conditions. Under both sets of temperature conditions the patients were uncomfortable during a longer period of time than the controls, and they were more sensitive to temperature changes, group II being more sensitive than group I. The comfort distribution curve was very narrow for group II. The performance tests were numerical addition, card punching, cue-utilization and creative association. In numerical addition no temperature effect could be shown on the speed of working, but for the patients in group II during heat stress the level of accuracy in the second hour was lower than under control conditions; the trend was the opposite for control subjects. No differences occurred in the first or third hour. In card punching the patients in group II worked significantly more slowly during heat stress than did the control subjects, who improved their performance in heat, as did the paracy with which this task was performed, the patients in group II making significantly more errors in the heat than patients in group I. Cue-utilization did not differ between groups or conditions. Patients performing the creative association test under heat stress supplied significantly fewer unique answers than did patients working under control conditions; no such effect of heat was observed for control subjects. We conclude that patients with IHD are more sensitive to moderate heat stress than healthy control subjects in terms of mental performance and comfort. There are some differences in cardiopulmonary function but no differences in thermoregulation.