Heat stroke natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2],Usama Talib, BSc, MD [3]

If heat stroke left untreated it may result in severe complications and even death. its complications include: multiple organ failure, acute renal failure, myocardial injury and even DIC. Timely resuscitation and fluid replacement decreases the mortality and can prevent sustained brain injury, which is the most important prognostic factor.

Heat stroke presents with altered mental status and signs of dehydration. Its symptoms develop in a susceptible person who did excessive exercise in hot weather. If left untreated it may result in severe complications and eventually death.

The complications of heat stroke include:^[1][2]

• Syndrome of multiorgan dysfunction
• Acute renal failure
• Myocardial injury
• Disseminated intravascular coagulation (DIC)

• Dehydration
• Electrolyte disturbances
• Encephalopathy
• Anterograde amnesia
• Acute respiratory distress syndrome
• Hepatocellular damage
• Rhabdomyolysis
• Acute renal failure
• Myocardial injury
• Hematologic complications
  • Disseminated intravascular coagulation (DIC)
  • Thrombocytopenia

The rare complications include:^[1][2]

• Bowel ischemia or infarction
• Pancreatic injury

The revival of the functioning of the central nervous system is a positive prognostic sign. It is usually seen following aggressive therapy. 20% patients face residual damage of the brain and a higher mortality is associated with this.^[3][4]