The Heart & the Hand
A man's hands can tell a lot abouthim—the kind of work he does, his attention to personal cleanliness,the extent of his vanity. Now, in the opinion of some moderncardiologists, the hand is a valuable clue not only to a man'soccupation and habits, but also, in many cases, to the condition of hisheart.
Dr. Mark E. Silverman and Dr. J. Willis Hurst of Atlanta's EmoryUniversity School of Medicine presented their latest hand-and-heartfindings to the American College of Cardiology last week. Although thecause and nature of a heart defect or disorder are often obscure, thedoctors suggested that these may become apparent to "the cardiovascularsleuth who lingers a moment longer at the radial pulse toinspect the hand closely."
Simian Crease. Countless babies are born with genetic heart defects andin many of these cases the genetic defect has visible, external effectsas well as internal ones. The most obvious example: mongolism,technically known as Down's syndrome, in which there may be heartdefects along with abnormalities of the hands—flabbiness, thickness, ashort fifth finger and a "simian crease" across the palm. Several othergenetic, chromosomally determined defects have comparable telltale handsigns.
More surprising was Dr. Silverman's report that heart disease acquiredrelatively late in life—including coronary occlusion—may be signaledby changes in the hand. Warm, moist hands with a fine tremor andoccasionally clubbing* of the fingers, he said, suggest the possibilityof an overactive thyroid with resulting inefficiency of the heart, andtwitching of its upper chambers. A cold hand with coarse, puffy skinmay be due to an underactive thyroid, and associated with fluid in theheart sac, a high blood-level of cholesterol, and even necrosis of partof the heart muscle from a coronary occlusion.
And Cancer Too. The clenched fist of a patient describing his chest painis a vivid illustration of the discomfort at the time of an occlusion.About two weeks after an otherwise undetected occlusion, the patientmay have a hand that is swollen, shiny, discoloredand stiff. The stiffness comes from thickening of the fibrous layerjust below the skin down the middle of the palm. It may pull thefingers together and sometimes also downward. Skin thickening andstiffness of this type may be the signs of a previous andhitherto-undetected coronary occlusion.
Even lung disease, including cancer, may be reflected in the hands, saidDr. Silverman. Emphysema, the currently common disease marked byinadequate oxygen intake at the lungs' surface, may produce clubbing ofthe fingers. The type of cancer that occurs most commonly in long-termmale cigarette smokers may eventually lead to acutely painful clubbingof the fingers and equally painful enlargement of the toe joints.
Typical of rheumatoid arthritis, which may have several adverse effectsupon the heart, said Silverman, is an outward turning of the fingers, along with thickening of the fingerjoints. In many hard-to-diagnose cases of heart disease, say theAtlanta doctors, the skilled physician's careful observation of thehands will yield valuable clues that the stethoscope and even theelectrocardiograph do not disclose.
* Thickening of the fingertip tissue.
Next:Scene Smothering
If you enjoyed this post, please consider to leave a comment or subscribe to the feed and get future articles delivered to your feed reader.
