SWEATING IN CONGENITAL HEART DISEASE
Blanche P. Alter M.D.1,
Emily E. Czapek M.D.1, and
Richard D. Rowe M.B.1
1 Department of Pediatrics, Johns Hopkins University School of Medicine and The Cardiac Clinic, Children's Medical and Surgical Center, The Johns Hopkins Hospital, Baltimore
Sweating was found to be increased in children with congenital heart disease who had a propensity to congestive heart failure, e.g., children with endocardial fibroelastosis or large or moderate sized left-to-right shunts. This was suggested in a review of cardiac clinic records of 220 patients and was supported by the results of pilocarpine sweat tests which were performed on 34 cardiac patients. By history and by measurement of the amount of sweat produced, children with a history of or tendency toward heart failure could be predicted though patients did not need to be in failure when tested. Contrary to previous opinion, the left-to-right shunt was not in itself sufficient to cause the child to sweat. The shunt had to be large enough to be associated with failure at some time.
It is suggested that the pilocarpine sweat test might actually be useful as an aid in predicting a child's potential for heart failure. Several theories regarding the mechanism of sweating in these situations are discussed.
Submitted on June 14, 1967
Accepted on August 24, 1967
