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__NOTOC__
{{SI}}
{{SI}}
{{CMG}}
{{CMG}}; {{AE}} {{Ochuko}}
 
{{SK}} Cold extremities; cold feet; cold hands and feet; cold hands


==Overview==
==Overview==
Cool extremities refers to a condition where the hands and feet are colder than the core of the body
Cool extremities refers to a condition where the hands and feet are colder than the core of the body.
 
==Causes==
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
 
*[[Aortic dissection]]
*[[Cardiac tamponade]]
*[[Disseminated intravascular coagulation]]
*[[Myocardial infarction]]
*[[Pulmonary embolism]]
 
===Common Causes===
*[[Cardiogenic shock]]
*[[Peripheral artery disease]]
*[[Raynaud's disease]]
*[[Septic shock]]
 
===Causes by Organ System===
 
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Acute limb ischemia]], [[aortic dissection]], [[arterial insufficiency]], [[Buerger's disease]], [[cardiac tamponade]], [[cardiogenic shock]], [[chronic venous disease]], [[circulatory disorders]], [[claudication]], [[coarctation of the aorta]], [[congenital heart disease]], [[congestive heart failure]], [[coronary heart disease]], [[embolization]], [[heart attack]], [[heart failure]], [[hemothorax]], [[hypoplastic left heart syndrome]], [[hypovolemia]], [[hypovolemic shock]], [[capillary leak syndrome|idiopathic systemic capillary leak syndrome]], [[myocardial infarction]], [[shock|neonatal shock]], [[neurogenic shock]], [[peripheral artery disease]], [[postural orthostatic tachycardia syndrome]], [[pulmonary embolism]], [[shock]], [[ST elevation myocardial infarction]], [[syncope]], [[vasoconstriction|systemic vasoconstriction]], [[Takayasu arteritis]], [[vasospasm]], [[vasovagal syncope]], [[wide complex tachycardia]]
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| Marine turtle poisoning, [[snakebite]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Acrocyanosis]], [[burns]], [[hyperhidrosis]], [[lupus]], [[meningococcal disease]], Pratesi syndrome, [[scleroderma]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Acebutolol]], [[alprenolol]], [[amlodipine]], [[atenolol]], [[beta blockers]], [[Butorphanol]], [[caduet]], [[carteolol]], [[esmolol]], [[isocarboxazid]], [[meperidine]], [[metoprolol]], [[nalbuphine]], [[oxprenolol]], [[oxymorphone]], [[pentamidine]], [[phenelzine]], [[pindolol]], [[propranolol]], [[rasagiline]], [[rilmenidine]], [[selegiline]], [[sotalol]], [[timolol]], [[tranylcypromine]], [[vasopressors]], [[vicodin]], [[ziac]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Diabetes insipidus]], [[diabetes mellitus]], [[hypothyroidism]], [[myxedema coma]], [[myxedema]], [[thyroid disease]], [[glycogen storage disease type I]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| [[Cold exposure]], [[frostbite]], [[hypothermia]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"|[[Glycogen storage disease type I]], [[scleroderma]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Cockayne syndrome]], [[glycogen storage disease type I]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Anemia]], [[bleeding]], [[disseminated intravascular coagulation]], [[meningococcal disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Hemodialysis]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[sepsis|Bacterial sepsis]], [[septic shock]], [[meningococcal disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Acute limb ischemia]], [[burns]], [[Raynaud's disease]], [[tarsal tunnel syndrome]], [[scleroderma]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Chronic fatigue syndrome]], [[Cockayne syndrome]], [[hyperhidrosis]], [[meningococcal disease]], [[restless legs syndrome]], [[subclavian steal syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Dehydration]], [[glycogen storage disease type I]], [[malnutrition]], [[starvation]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| [[acetylsalicylic acid|Acetylsalicylic acid overdose]], [[alcohol withdrawal]], [[drug overdose]], [[hydrocodone overdose]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Alcohol withdrawal]], [[anxiety]], [[chronic fatigue syndrome]], [[emetophobia]], [[night terror]], [[nightmare]], [[panic attack]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Hemothorax]], [[scleroderma]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Acute kidney injury]], [[acute tubular necrosis]], [[dehydration]], [[lactic acidosis]], [[lupus]], [[scleroderma]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Buerger's disease]], [[chronic fatigue syndrome]], [[lupus]], [[Raynaud's disease]], [[Raynaud's phenomenon]], [[scleroderma]], [[Sjogren's syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Trauma]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Hypothermia]]
|-
|}


==Differential Diagnosis of Cool Extremities==
===Causes in Alphabetical Order===
*[[Acetylsalicylic acid]] overdose
{{col-begin|width=80%}}
{{col-break|width=33%}}
*[[Abdominal aortic aneurysm]]<ref name="pmid7944047">{{cite journal| author=Patel H, Krishnamoorthy M, Dorazio RA, Abu Dalu J, Humphrey R, Tyrell J| title=Thrombosis of abdominal aortic aneurysms. | journal=Am Surg | year= 1994 | volume= 60 | issue= 10 | pages= 801-3 | pmid=7944047 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7944047  }} </ref>
*[[Acebutolol]]
*[[acetylsalicylic acid|Acetylsalicylic acid overdose]]
*[[Acrocyanosis]]
*[[Acrocyanosis]]
*[[Acute kidney injury]]
*[[Acute limb ischemia]]
*[[Acute tubular necrosis]]
*[[Alcohol withdrawal]]
*[[Alcohol withdrawal]]
*[[Alprenolol]]
*[[Amlodipine]]
*[[Amlodipine]]
*[[Anemia]]
*[[Anxiety]]
*[[Anxiety]]
*[[Aortic dissection]]
*[[Aortic dissection]]
*[[Beta blockers]]
*[[Arterial insufficiency]]
*[[Bleeding]]
*[[Atenolol]]
*[[sepsis|Bacterial sepsis]]
*[[Beta blockers]]<ref name="pmid24431932">{{cite journal| author=Sharma VK, Fraulin FO, Dumestre DO, Walker L, Harrop AR| title=Beta-blockers for the treatment of problematic hemangiomas. | journal=Can J Plast Surg | year= 2013 | volume= 21 | issue= 1 | pages= 23-8 | pmid=24431932 | doi= | pmc=PMC3891114 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24431932  }} </ref>
*[[Bleeding]]
*[[Buerger's disease]]
*[[Burns]]
*[[Burns]]
*[[Caduet]]
*[[Caduet]]
*[[Cardiogenic shock]]
*[[Cardiac tamponade]]
*[[Cardiac tamponade]]
*[[Cardiogenic shock]]
*[[Carteolol]]
*[[Chronic fatigue syndrome]]
*[[Chronic fatigue syndrome]]
*[[Chronic venous disease]]
*[[Circulatory disorders]]
*[[Claudication]]
*[[Claudication]]
*[[Coarctation of the aorta]]
*[[Cockayne syndrome]]
*[[Cold exposure]]
*[[Congenital heart disease]]
*[[Congestive heart failure]]
*[[Congestive heart failure]]
*Drug overdose
*[[Coronary heart disease]]
*[[Embolization]]
*[[Dehydration]]
*[[Emetophobia]]
*[[Diabetes insipidus]]
*[[Diabetes mellitus]]
*[[Disseminated intravascular coagulation]]
{{col-break|width=33%}}
*[[Drug overdose]]
*[[Embolization]]<ref name="pmid4025951">{{cite journal| author=Loh FK| title=Embolization of a sciatic artery aneurysm an alternative to surgery: a case report. | journal=Angiology | year= 1985 | volume= 36 | issue= 7 | pages= 472-6 | pmid=4025951 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4025951  }} </ref>
*[[Emetophobia]]
*[[Esmolol]]
*[[Frostbite]]
*[[Glycogen storage disease type I]]
*[[Glycogen storage disease type I]]
*[[Heart attack]]
*[[Heart attack]]
*[[Hemodialysis]]
*[[Heart failure]]
*[[Hemodialysis]]  
*[[Hemothorax]]
*[[Hemothorax]]
*[[Hydrocodone overdose]]
*[[Hydrocodone overdose]]
*[[Hyperhidrosis]]
*[[Hyperhidrosis]]  
*[[Hypoplastic left heart syndrome]]
*[[Hypoplastic left heart syndrome]]
*[[Hypothermia]]
*[[Hypothermia]]  
*[[Hypothyroidism]]
*[[Hypothyroidism]]
*[[Hypovolemia]]
*[[Hypovolemic shock]]
*[[Hypovolemic shock]]
*[[capillary leak syndrome|Idiopathic systemic capillary leak syndrome]]
*[[Isocarboxazid]]
*[[Isocarboxazid]]
*[[Limb ischemia]]
*[[Lactic acidosis]]
*[[Lupus]]
*[[Malnutrition]]
*Marine turtle poisoning
*[[Meningococcal disease]]  
*[[Meperidine]]
*[[Meperidine]]
*[[Metoprolol]]
*[[Myocardial infarction]]
*[[Myocardial infarction]]
*[[Myxedema]]
*[[Myxedema]]
*[[Myxedema coma]]
*[[Nalbuphine]]
*[[Nalbuphine]]
*[[Neurogenic shock]]
*[[shock|Neonatal shock]]
*[[Neurogenic shock]]  
*[[Night terror]]
*[[Night terror]]
*[[Nightmare]]
*[[Nightmare]]
*[[Oxprenolol]]
*[[Oxymorphone]]
*[[Oxymorphone]]
*[[Panic attack]]
*[[Panic attack]]
*[[Pentamadine]]
{{col-break|width=33%}}
*[[Peripheral arterial disease]]
*[[Pentamidine]]
*[[Phenelzine]]
*[[Peripheral artery disease]]
*[[Pheochromocytoma]]<ref name="pmid6280403">{{cite journal| author=Quietzsch D| title=[Pheochromocytoma and shock]. | journal=Z Gesamte Inn Med | year= 1982 | volume= 37 | issue= 1 | pages= 32-4 | pmid=6280403 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6280403  }} </ref>
*[[Phenelzine]]
*[[Pindolol]]
*[[Postural orthostatic tachycardia syndrome]]
*[[Postural orthostatic tachycardia syndrome]]
*Pratesi syndrome
*[[Propranolol]]
*[[Pulmonary embolism]]
*[[Pulmonary embolism]]
*[[Rasagiline]]
*[[Rasagiline]]
*[[Raynaud's disease]]
*[[Raynaud's phenomenon]]
*[[Raynaud's phenomenon]]
*[[Rilmenidine]]
*[[Restless legs syndrome]]
*[[Rilmenidine]]
*[[Scleroderma]]
*[[Selegiline]]
*[[Selegiline]]
*[[Septic shock]]
*[[Shock]]
*[[Sjogren's syndrome]]
*[[Snakebite]]
*[[Snakebite]]
*[[Starvation]]
*[[Sotalol]]  
*[[ST elevation myocardial infarction]]
*[[ST elevation myocardial infarction]]  
*[[Tamponade]]
*[[Starvation]]
*[[Tranylcypromine]]
*[[Subclavian steal syndrome]]
*[[Syncope]]
*[[vasoconstriction|Systemic vasoconstriction]]
*[[Takayasu arteritis]]<ref name="pmid9231628">{{cite journal| author=Dabrowski GP, Akers DL| title=Takayasu's arteritis: management of a complex case and literature review. | journal=J La State Med Soc | year= 1997 | volume= 149 | issue= 6 | pages= 250-3 | pmid=9231628 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9231628  }} </ref>
*[[Tarsal tunnel syndrome]]
*[[Thyroid disease]]
*[[Timolol]]
*[[Tranylcypromine]]  
*[[Trauma]]
*[[Trauma]]
*Systemic [[vasoconstriction]]
*[[Vasopressors]]
*[[Vasopressors]]
*[[Vasovagal syncope]]
*[[Vasospasm]]
*[[Vicodin]]
*[[Vasovagal syncope]]  
*[[Vicodin]]
*[[Wide complex tachycardia]]  
*[[Ziac]]
*[[Ziac]]
{{col-end}}
==Differential Diagnosis of the Patient with Cool Extremities and Sweating or Diaphoresis, or "A Cold Sweat"==
*[[Alcohol withdrawal]]
*[[Anxiety]]
*[[Nightmare]]
*[[Night terror]]
*[[Panic attack]]
*[[Shock]]
*[[ST Elevation Myocardial Infarction]]
*[[Trauma]]
*[[Vagal episode]]


In contrast to the patient with [[cardiogenic shock]] and [[hypovolemic shock]], the patient with [[septic shock]] will often have warm extremities.
In contrast to the patient with [[cardiogenic shock]] and [[hypovolemic shock]], the patient with [[septic shock]] will often have warm extremities.
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Crowdiagnosis]]


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Latest revision as of 21:00, 16 January 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Synonyms and keywords: Cold extremities; cold feet; cold hands and feet; cold hands

Overview

Cool extremities refers to a condition where the hands and feet are colder than the core of the body.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Acute limb ischemia, aortic dissection, arterial insufficiency, Buerger's disease, cardiac tamponade, cardiogenic shock, chronic venous disease, circulatory disorders, claudication, coarctation of the aorta, congenital heart disease, congestive heart failure, coronary heart disease, embolization, heart attack, heart failure, hemothorax, hypoplastic left heart syndrome, hypovolemia, hypovolemic shock, idiopathic systemic capillary leak syndrome, myocardial infarction, neonatal shock, neurogenic shock, peripheral artery disease, postural orthostatic tachycardia syndrome, pulmonary embolism, shock, ST elevation myocardial infarction, syncope, systemic vasoconstriction, Takayasu arteritis, vasospasm, vasovagal syncope, wide complex tachycardia
Chemical/Poisoning Marine turtle poisoning, snakebite
Dental No underlying causes
Dermatologic Acrocyanosis, burns, hyperhidrosis, lupus, meningococcal disease, Pratesi syndrome, scleroderma
Drug Side Effect Acebutolol, alprenolol, amlodipine, atenolol, beta blockers, Butorphanol, caduet, carteolol, esmolol, isocarboxazid, meperidine, metoprolol, nalbuphine, oxprenolol, oxymorphone, pentamidine, phenelzine, pindolol, propranolol, rasagiline, rilmenidine, selegiline, sotalol, timolol, tranylcypromine, vasopressors, vicodin, ziac
Ear Nose Throat No underlying causes
Endocrine Diabetes insipidus, diabetes mellitus, hypothyroidism, myxedema coma, myxedema, thyroid disease, glycogen storage disease type I
Environmental Cold exposure, frostbite, hypothermia
Gastroenterologic Glycogen storage disease type I, scleroderma
Genetic Cockayne syndrome, glycogen storage disease type I
Hematologic Anemia, bleeding, disseminated intravascular coagulation, meningococcal disease
Iatrogenic Hemodialysis
Infectious Disease Bacterial sepsis, septic shock, meningococcal disease
Musculoskeletal/Orthopedic Acute limb ischemia, burns, Raynaud's disease, tarsal tunnel syndrome, scleroderma
Neurologic Chronic fatigue syndrome, Cockayne syndrome, hyperhidrosis, meningococcal disease, restless legs syndrome, subclavian steal syndrome
Nutritional/Metabolic Dehydration, glycogen storage disease type I, malnutrition, starvation
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity Acetylsalicylic acid overdose, alcohol withdrawal, drug overdose, hydrocodone overdose
Psychiatric Alcohol withdrawal, anxiety, chronic fatigue syndrome, emetophobia, night terror, nightmare, panic attack
Pulmonary Hemothorax, scleroderma
Renal/Electrolyte Acute kidney injury, acute tubular necrosis, dehydration, lactic acidosis, lupus, scleroderma
Rheumatology/Immunology/Allergy Buerger's disease, chronic fatigue syndrome, lupus, Raynaud's disease, Raynaud's phenomenon, scleroderma, Sjogren's syndrome
Sexual No underlying causes
Trauma Trauma
Urologic No underlying causes
Miscellaneous Hypothermia

Causes in Alphabetical Order

Differential Diagnosis of the Patient with Cool Extremities and Sweating or Diaphoresis, or "A Cold Sweat"

In contrast to the patient with cardiogenic shock and hypovolemic shock, the patient with septic shock will often have warm extremities.

References

  1. ↑ Patel H, Krishnamoorthy M, Dorazio RA, Abu Dalu J, Humphrey R, Tyrell J (1994). "Thrombosis of abdominal aortic aneurysms". Am Surg. 60 (10): 801–3. PMID 7944047.
  2. ↑ Sharma VK, Fraulin FO, Dumestre DO, Walker L, Harrop AR (2013). "Beta-blockers for the treatment of problematic hemangiomas". Can J Plast Surg. 21 (1): 23–8. PMC 3891114. PMID 24431932.
  3. ↑ Loh FK (1985). "Embolization of a sciatic artery aneurysm an alternative to surgery: a case report". Angiology. 36 (7): 472–6. PMID 4025951.
  4. ↑ Quietzsch D (1982). "[Pheochromocytoma and shock]". Z Gesamte Inn Med. 37 (1): 32–4. PMID 6280403.
  5. ↑ Dabrowski GP, Akers DL (1997). "Takayasu's arteritis: management of a complex case and literature review". J La State Med Soc. 149 (6): 250–3. PMID 9231628.

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