Cold hands, warm and stressed heart

The case for hand temperature as a vital sign

You are running about 30 minutes late seeing patients. They are waiting. They are waiting for you. Your heart is beating quickly, as if spurring you to keep up. The last person had so many problems. You absorbed them long enough to understand, to plan, to move on as you must. Your hands are ice cold. And it’s not even that chilly in the office.

Or perhaps you are waiting for the doctor who is running late. You have worries. Health worries, mental health worries, and worries about unknown worries. You’ll have 20 minutes at best to spill them out. And what may come next might not be good. Your heart is beating quickly, your blood pressure reading higher than usual. Your hands are ice cold. And it’s not even that chilly in the examining room.

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Among other physiologic responses, stress and anxiety activate the sympathetic nervous system, release adrenaline and cortisol, and clamp down the peripheral arterial circulation. We’ve all experienced this as fast heart rates, cold swea…