What to do if there is sudden onset of sweating (diaphoresis)?

From the Guidelines

If you're experiencing sudden unexplained dizziness (SUD), call emergency services (911) immediately if it's severe or accompanied by other symptoms like chest pain, difficulty breathing, slurred speech, or facial drooping, as these could indicate a serious condition like stroke or heart attack 1. When experiencing SUD, it's essential to prioritize your safety and the potential risks associated with the condition. According to the 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction, patients with symptoms that may represent acute coronary syndrome (ACS) should not be evaluated solely over the telephone but should be referred to a facility that allows evaluation by a physician and the recording of a 12-lead ECG and biomarker determination (eg, an ED or other acute care facility) 1. Some key points to consider when experiencing SUD include:

• Sitting or lying down immediately to prevent falling and potential injury
• Staying in this position until the dizziness subsides
• Avoiding sudden movements or position changes
• Trying to drink water as dehydration can cause dizziness
• Consulting a healthcare provider if dizziness persists or recurs, as they may prescribe medications or recommend further testing to determine the underlying cause 1. It's crucial to note that SUD can result from various conditions, including inner ear problems, low blood pressure, medication side effects, or more serious conditions like stroke or heart attack, emphasizing the importance of professional evaluation for persistent symptoms 1.

From the Research

Management of Chest Pain

• The management of chest pain involves the administration of aspirin, unless contraindicated, as it is a class I guideline recommended medical treatment for acute coronary syndrome 2, 3.
• Other medical therapies that may be used to manage chest pain include statins, angiotensin-converting enzyme inhibitors, beta blockers, nitroglycerin, and morphine 3.
• For patients with an ST-segment elevation myocardial infarction, percutaneous coronary intervention (PCI) with stent placement should be performed as soon as possible 3.
• If patients require coronary artery bypass graft to reestablish coronary artery flow, it ideally is delayed 3 to 7 days after admission unless the patient has cardiogenic shock, life-threatening arrhythmias, three-vessel disease, or other complications 3.

Administration of Aspirin

• Early administration of aspirin, within two hours of the onset of chest pain, may be associated with increased survival compared to late administration 4.
• The ideal dose of aspirin is uncertain, but it is recommended for all patients with a suspected acute coronary syndrome unless contraindicated 2, 3.
• Aspirin may be administered as part of first-aid management for non-traumatic adult chest pain, and it is recommended to be given as soon as possible after the onset of symptoms 4, 5.

Diagnosis and Risk Stratification

• Chest pain is a common presentation and diagnosis can be challenging, with many causes including life-threatening conditions such as acute coronary syndrome (ACS) 5, 6.
• An electrocardiogram (ECG) is the only investigation required for most patients with suspected ACS in the primary care setting, while referral is made to hospital 5.
• Shortness of breath (SOB) is a key symptom in patients with ACS, but its value in recognising ACS during telephone triage in the out-of-hours primary care setting is uncertain 6.