Heat stroke history and symptoms

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

Overview

High body temperature (hyperthermia) and dysfunction of the CNS must coexist for the confirmation of the diagnosis of heat stroke. A history of an existing disease, outdoor activity, exposure to heat, extensive exertion and improper hydration may be observed.^[1]^[2]^[3]

History

A detailed history is necessary for the prompt diagnosis of heat stroke. The patient with heat stroke may hav ethe following salient features in the history:^[3]^[4]^[5]

Non-exertional or Classic Heat Stroke

The history of a patient with classic heat stroke inludes:^[6]^[7]^[8]^[9]

Old age
Chronic condition effecting thermoregulation
Cardiovascular illness
Alcohol use
Drugs
- Cocaine
- Ecstasy
Prescription drugs
Anhidrosis
Disability
Obesity
Job in hot surroundings
- Cooking
- Iron molding
- Thermal plants

Exertional Heat Stroke

A patient with exertional heat stroke may have the following salient features in the history:^[10]^[11]

Young age
Heavy exercise
Humid weather
Otherwise helathy individuals
Military personnel
Athletes
Construction workers

Symptoms

The symptoms of a heat stroke include:

Hyperthermia (40-47C)
CNS dysfunction
Red dry skin
Nausea
Muscle soreness
Seizures may be rarely seen

References

↑ Simon HB (1994). “Hyperthermia and heatstroke”. Hosp Pract (Off Ed). 29 (8): 65–8, 73, 78–80. PMID 7914522.
↑ Bricknell MC (1994). “Heat illness in Cyprus”. J R Army Med Corps. 140 (2): 67–9. PMID 8907832.
↑ ^3.0 ^3.1 Leon LR, Bouchama A (2015). “Heat stroke”. Compr Physiol. 5 (2): 611–47. doi:10.1002/cphy.c140017. PMID 25880507.
↑ Bouchama A, Cafege A, Devol EB, Labdi O, el-Assil K, Seraj M (1991). “Ineffectiveness of dantrolene sodium in the treatment of heatstroke”. Crit Care Med. 19 (2): 176–80. PMID 1989755.
↑ Klenk J, Becker C, Rapp K (2010). “Heat-related mortality in residents of nursing homes”. Age Ageing. 39 (2): 245–52. doi:10.1093/ageing/afp248. PMID 20093248. Review in: Evid Based Nurs. 2010 Jul;13(3):90-1
↑ Bouchama A, Knochel JP (2002). “Heat stroke”. N Engl J Med. 346 (25): 1978–88. doi:10.1056/NEJMra011089. PMID 12075060.
↑ Brody GM (1994). “Hyperthermia and hypothermia in the elderly”. Clin Geriatr Med. 10 (1): 213–29. PMID 8168025.
↑ Dann EJ, Berkman N (1992). “Chronic idiopathic anhydrosis–a rare cause of heat stroke”. Postgrad Med J. 68 (803): 750–2. PMC 2399451. PMID 1480539.
↑ Flynn A, McGreevy C, Mulkerrin EC (2005). “Why do older patients die in a heatwave?”. QJM. 98 (3): 227–9. doi:10.1093/qjmed/hci025. PMID 15728404.
↑ Bendahan D, Kozak-Ribbens G, Confort-Gouny S, Ghattas B, Figarella-Branger D, Aubert M; et al. (2001). “A noninvasive investigation of muscle energetics supports similarities between exertional heat stroke and malignant hyperthermia”. Anesth Analg. 93 (3): 683–9. PMID 11524341.
↑ Hirshey Dirksen SJ, Larach MG, Rosenberg H, Brandom BW, Parness J, Lang RS; et al. (2011). “Special article: Future directions in malignant hyperthermia research and patient care”. Anesth Analg. 113 (5): 1108–19. doi:10.1213/ANE.0b013e318222af2e. PMC 3184381. PMID 21709147.

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[pmid7914522-1] Simon HB (1994). “Hyperthermia and heatstroke”. Hosp Pract (Off Ed). 29 (8): 65–8, 73, 78–80. PMID 7914522.

[pmid8907832-2] Bricknell MC (1994). “Heat illness in Cyprus”. J R Army Med Corps. 140 (2): 67–9. PMID 8907832.

[pmid25880507-3] 3.0 ^3.1 Leon LR, Bouchama A (2015). “Heat stroke”. Compr Physiol. 5 (2): 611–47. doi:10.1002/cphy.c140017. PMID 25880507.

[pmid1989755-4] Bouchama A, Cafege A, Devol EB, Labdi O, el-Assil K, Seraj M (1991). “Ineffectiveness of dantrolene sodium in the treatment of heatstroke”. Crit Care Med. 19 (2): 176–80. PMID 1989755.

[pmid20093248-5] Klenk J, Becker C, Rapp K (2010). “Heat-related mortality in residents of nursing homes”. Age Ageing. 39 (2): 245–52. doi:10.1093/ageing/afp248. PMID 20093248. Review in: Evid Based Nurs. 2010 Jul;13(3):90-1

[pmid12075060-6] Bouchama A, Knochel JP (2002). “Heat stroke”. N Engl J Med. 346 (25): 1978–88. doi:10.1056/NEJMra011089. PMID 12075060.

[pmid8168025-7] Brody GM (1994). “Hyperthermia and hypothermia in the elderly”. Clin Geriatr Med. 10 (1): 213–29. PMID 8168025.

[pmid1480539-8] Dann EJ, Berkman N (1992). “Chronic idiopathic anhydrosis–a rare cause of heat stroke”. Postgrad Med J. 68 (803): 750–2. PMC 2399451. PMID 1480539.

[pmid15728404-9] Flynn A, McGreevy C, Mulkerrin EC (2005). “Why do older patients die in a heatwave?”. QJM. 98 (3): 227–9. doi:10.1093/qjmed/hci025. PMID 15728404.

[pmid11524341-10] Bendahan D, Kozak-Ribbens G, Confort-Gouny S, Ghattas B, Figarella-Branger D, Aubert M; et al. (2001). “A noninvasive investigation of muscle energetics supports similarities between exertional heat stroke and malignant hyperthermia”. Anesth Analg. 93 (3): 683–9. PMID 11524341.

[pmid21709147-11] Hirshey Dirksen SJ, Larach MG, Rosenberg H, Brandom BW, Parness J, Lang RS; et al. (2011). “Special article: Future directions in malignant hyperthermia research and patient care”. Anesth Analg. 113 (5): 1108–19. doi:10.1213/ANE.0b013e318222af2e. PMC 3184381. PMID 21709147.

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