Heat stroke natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
If heat stroke left untreated it may result in severe complications and even death. its complications include: | 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. | ||
==Natural History== | ==Natural History== | ||
Heat stroke presents with altered mental status and signs of dehydration. Its symptoms develop in a susceptible person who | 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. | ||
==Complications== | ==Complications== | ||
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===Life Threatening complications=== | ===Life Threatening complications=== | ||
*Syndrome of multiorgan dysfunction | *[[Multiple organ dysfunction syndrome|Syndrome of multiorgan dysfunction]] | ||
*Acute renal failure | *[[Acute kidney injury|Acute renal failure]] | ||
*Myocardial injury | *[[Myocardial injury]] | ||
*Disseminated intravascular coagulation ([[DIC]]) | *Disseminated intravascular coagulation ([[DIC]]) | ||
===Common Complications=== | ===Common Complications=== | ||
*Dehydration | *[[Dehydration]] | ||
*Electrolyte disturbances | *[[Electrolyte disturbances]] | ||
*Encephalopathy | *[[Encephalopathy]] | ||
*Acute respiratory distress syndrome | *[[Anterograde amnesia]] | ||
*[[Acute respiratory distress syndrome]] | |||
*Hepatocellular damage | *Hepatocellular damage | ||
*Rhabdomyolysis | *[[Rhabdomyolysis]] | ||
*Acute renal failure | *[[Acute kidney injury|Acute renal failure]] | ||
*Myocardial injury | *[[Myocardial injury]] | ||
*Hematologic complications | *Hematologic complications | ||
**Disseminated intravascular coagulation ([[DIC]]) | **Disseminated intravascular coagulation ([[DIC]]) | ||
**Thrombocytopenia | **[[Thrombocytopenia]] | ||
===Rare Complications=== | ===Rare Complications=== | ||
The rare complications include:<ref name="pmid27840645">{{cite journal| author=Masood U, Sharma A, Syed W, Manocha D| title=Bowel Ischemia from Heat Stroke: A Rare Presentation of an Uncommon Complication. | journal=Case Rep Med | year= 2016 | volume= 2016 | issue= | pages= 5217690 | pmid=27840645 | doi=10.1155/2016/5217690 | pmc=5093235 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27840645 }} </ref><ref name="pmid7865679">{{cite journal| author=al-Mashhadani SA, Gader AG, al Harthi SS, Kangav D, Shaheen FA, Bogus F| title=The coagulopathy of heat stroke: alterations in coagulation and fibrinolysis in heat stroke patients during the pilgrimage (Haj) to Makkah. | journal=Blood Coagul Fibrinolysis | year= 1994 | volume= 5 | issue= 5 | pages= 731-6 | pmid=7865679 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7865679 }} </ref> | The rare complications include:<ref name="pmid27840645">{{cite journal| author=Masood U, Sharma A, Syed W, Manocha D| title=Bowel Ischemia from Heat Stroke: A Rare Presentation of an Uncommon Complication. | journal=Case Rep Med | year= 2016 | volume= 2016 | issue= | pages= 5217690 | pmid=27840645 | doi=10.1155/2016/5217690 | pmc=5093235 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27840645 }} </ref><ref name="pmid7865679">{{cite journal| author=al-Mashhadani SA, Gader AG, al Harthi SS, Kangav D, Shaheen FA, Bogus F| title=The coagulopathy of heat stroke: alterations in coagulation and fibrinolysis in heat stroke patients during the pilgrimage (Haj) to Makkah. | journal=Blood Coagul Fibrinolysis | year= 1994 | volume= 5 | issue= 5 | pages= 731-6 | pmid=7865679 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7865679 }} </ref> | ||
*Bowel ischemia or infarction | *[[Bowel ischemia]] or infarction | ||
*Pancreatic injury | *Pancreatic injury | ||
Latest revision as of 22:23, 30 May 2017
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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]
Overview
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.
Natural History
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.
Complications
The complications of heat stroke include:[1][2]
Life Threatening complications
- Syndrome of multiorgan dysfunction
- Acute renal failure
- Myocardial injury
- Disseminated intravascular coagulation (DIC)
Common Complications
- 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
Rare Complications
The rare complications include:[1][2]
- Bowel ischemia or infarction
- Pancreatic injury
Prognosis
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]
References
- ↑ 1.0 1.1 Masood U, Sharma A, Syed W, Manocha D (2016). "Bowel Ischemia from Heat Stroke: A Rare Presentation of an Uncommon Complication". Case Rep Med. 2016: 5217690. doi:10.1155/2016/5217690. PMC 5093235. PMID 27840645.
- ↑ 2.0 2.1 al-Mashhadani SA, Gader AG, al Harthi SS, Kangav D, Shaheen FA, Bogus F (1994). "The coagulopathy of heat stroke: alterations in coagulation and fibrinolysis in heat stroke patients during the pilgrimage (Haj) to Makkah". Blood Coagul Fibrinolysis. 5 (5): 731–6. PMID 7865679.
- ↑ Hart GR, Anderson RJ, Crumpler CP, Shulkin A, Reed G, Knochel JP (1982). "Epidemic classical heat stroke: clinical characteristics and course of 28 patients". Medicine (Baltimore). 61 (3): 189–97. PMID 7078400.
- ↑ Dematte JE, O'Mara K, Buescher J, Whitney CG, Forsythe S, McNamee T; et al. (1998). "Near-fatal heat stroke during the 1995 heat wave in Chicago". Ann Intern Med. 129 (3): 173–81. PMID 9696724.