Heat stroke differential diagnosis

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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]

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.