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Differentiation between 2 types of heat stroke (Classic vs Exertional) is based on history, clinical findings, and laboratory findings.
Differentiation between 2 types of heat stroke (Classic vs Exertional) is based on history, clinical findings, and laboratory findings.
The following table summarizes their differentiating feature.
The following table summarizes their differentiating feature.
{| class="wikitable"
<br>
! colspan="2" |Characteristic
{| align=center
!Exertional Heat Stroke
!Classic Heat Stroke
|-
|-
| colspan="2" |Age
|
|Adults
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|Early childhood or elderly
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Characteristic
!align="center" style="background:#4479BA; color: #FFFFFF;" |Exertional Heat Stroke
!align="center" style="background:#4479BA; color: #FFFFFF;" |Classic Heat Stroke
|-
|-
| colspan="2" |Health status
| colspan="2" align="center" style="background:#DCDCDC;"|Age
|Healthy and athlete
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Adults
|Ill and debilitate
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Early childhood or elderly
|-
|-
| colspan="2" |Weather condition
| colspan="2" align="center" style="background:#DCDCDC;"|Health status
|Temperate or hot
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Healthy and athlete
|Heat wave
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Ill and debilitate
|-
|-
| colspan="2" |Activity
| colspan="2" align="center" style="background:#DCDCDC;"|Weather condition
|Sustained or heavy exertion
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Temperate or hot
|Sedentary
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Heat wave
|-
|-
| colspan="2" |Medications or drug use
| colspan="2" align="center" style="background:#DCDCDC;"|Activity
|Ergogenic aids, ecstasy, cocaine
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Sustained or heavy exertion
|Diuretics, β-blockers, antihistamines,
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Sedentary
|-
| colspan="2" align="center" style="background:#DCDCDC;"|Medications or drug use
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Ergogenic aids, ecstasy, cocaine
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diuretics, β-blockers, antihistamines,
antidepressants
antidepressants
|-
|-
| colspan="2" |Sweating
| colspan="2" align="center" style="background:#DCDCDC;"|Sweating
|Present
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Present
|Abscent
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Abscent
|-
|-
| rowspan="7" |Laboratory findings
| rowspan="7" align="center" style="background:#DCDCDC;"|Laboratory findings
|Acid-base disturbance
|align="center" style="background:#DCDCDC;"|Acid-base disturbance
|Metabolic acidosis
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Metabolic acidosis
|Mixed metabolic and respiratory acidosis
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Mixed metabolic and respiratory acidosis
|-
|-
|Calcium
|align="center" style="background:#DCDCDC;"|Calcium
|↓
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
|Nl
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
|-
|-
|Potassium
|align="center" style="background:#DCDCDC;"|Potassium
|↓ or ↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓ or ↑
|Nl
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
|-
|-
|Phosphate
|align="center" style="background:#DCDCDC;"|Phosphate
|↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
|↓
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
|-
|-
|Blood glucose
|align="center" style="background:#DCDCDC;"|Blood glucose
|↓
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
|↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
|-
|-
|Creatine kinase (CK)
|align="center" style="background:#DCDCDC;"|Creatine kinase (CK)
|↑↑↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑↑↑
|↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
|-
|-
|AST, ALT
|align="center" style="background:#DCDCDC;"|AST, ALT
|↑↑↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑↑↑
|↑
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
|-
|-
| rowspan="2" |Complications
| rowspan="2" align="center" style="background:#DCDCDC;"|Complications
|Rhabdomyolysis
|align="center" style="background:#DCDCDC;"|Rhabdomyolysis
|Severe
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Severe
|Mild
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Mild
|-
|-
|Acute renal failure
|align="center" style="background:#DCDCDC;"|Acute renal failure
|Common (∼25%)
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Common (∼25%)
|Uncommon (∼5%)
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Uncommon (∼5%)
|}
|}
<br>Heat stroke must be differentiated from other conditions that may cause hyperthermia.
<br>Heat stroke must be differentiated from other conditions that may cause hyperthermia.

Revision as of 16:34, 24 May 2017

Heat stroke Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Heat Stroke from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

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MRI

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Treatment

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Surgery

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Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

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Risk calculators and risk factors for Heat stroke differential diagnosis

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

Overview

Differentiating Heat stroke from other Diseases

Differentiation between 2 types of heat stroke (Classic vs Exertional) is based on history, clinical findings, and laboratory findings. The following table summarizes their differentiating feature.

Characteristic Exertional Heat Stroke Classic Heat Stroke
Age Adults Early childhood or elderly
Health status Healthy and athlete Ill and debilitate
Weather condition Temperate or hot Heat wave
Activity Sustained or heavy exertion Sedentary
Medications or drug use Ergogenic aids, ecstasy, cocaine Diuretics, β-blockers, antihistamines,

antidepressants

Sweating Present Abscent
Laboratory findings Acid-base disturbance Metabolic acidosis Mixed metabolic and respiratory acidosis
Calcium ↓ Nl
Potassium ↓ or ↑ Nl
Phosphate ↑ ↓
Blood glucose ↓ ↑
Creatine kinase (CK) ↑↑↑ ↑
AST, ALT ↑↑↑ ↑
Complications Rhabdomyolysis Severe Mild
Acute renal failure Common (∼25%) Uncommon (∼5%)


Heat stroke must be differentiated from other conditions that may cause hyperthermia.

References
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