Heat stroke overview

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Heat Stroke from other Diseases

Epidemiology and Demographics

Risk Factors

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Natural History, Complications and Prognosis

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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

Historical perspective

Heat stroke was first described by Hippocrates in 400 BC. Its prevention and treatment then described by Avicenna in 1020. Recent treatment advances is because of military experiences with heat exposure.

Classification

Heat stroke is classified to 2 types: Exertional heat stroke (EHS) generally occurs in young individuals who engage in strenuous physical activity for a prolonged period in a hot environment and classic nonexertional heat stroke (NEHS) more commonly affects sedentary elderly individuals, persons who are chronically ill, and very young persons.[1]

Pathophysiology

Causes

Excessive exercise in warm weather is the most common cause heat stroke.[1]

Differentiating Heat stroke from other Diseases

Heat stroke must be differentiated from other disease that may cause alteration in mental status and hyperthermia including: Neuroleptic malignant syndrome, Malignant hyperthermia, Serotonin syndrome, and sepsis.[2][3][4][5][6][7]

Epidemiology and demographics

The United States Centers for Disease Control (CDC) reports an average of 9000 cases per year among high school athletes. The highest incidence of heat stroke in the United States has been reported among football players. Young athletes are more prone to exertional heat stroke while, classic heat stroke is more common among elderly. Men are more affected by heat stroke than women.

References

  1. Bouchama A, Knochel JP (2002). "Heat stroke". N. Engl. J. Med. 346 (25): 1978–88. doi:10.1056/NEJMra011089. PMID 12075060.
  2. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC (2016). "The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)". JAMA. 315 (8): 801–10. doi:10.1001/jama.2016.0287. PMC 4968574. PMID 26903338.
  3. Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, Rubenfeld G, Kahn JM, Shankar-Hari M, Singer M, Deutschman CS, Escobar GJ, Angus DC (2016). "Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)". JAMA. 315 (8): 762–74. doi:10.1001/jama.2016.0288. PMC 5433435. PMID 26903335.
  4. Carbone JR (2000). "The neuroleptic malignant and serotonin syndromes". Emerg. Med. Clin. North Am. 18 (2): 317–25, x. PMID 10767887.
  5. Bodner RA, Lynch T, Lewis L, Kahn D (1995). "Serotonin syndrome". Neurology. 45 (2): 219–23. PMID 7854515.
  6. Ener RA, Meglathery SB, Van Decker WA, Gallagher RM (2003). "Serotonin syndrome and other serotonergic disorders". Pain Med. 4 (1): 63–74. PMID 12873279.
  7. Larach MG, Gronert GA, Allen GC, Brandom BW, Lehman EB (2010). "Clinical presentation, treatment, and complications of malignant hyperthermia in North America from 1987 to 2006". Anesth. Analg. 110 (2): 498–507. doi:10.1213/ANE.0b013e3181c6b9b2. PMID 20081135.