Definition

By Mayo Clinic Staff

Heatstroke is caused by prolonged exposure to high
temperatures or by doing physical activity in hot
weather. You are considered to have heatstroke when
your body temperature reaches 104 F (40 C) or higher.
High humidity, certain health problems and some
medications increase your risk of heatstroke. So does
being a young child or older adult.
Heatstroke is the progression of two worsening heat-
related conditions. When your body overheats, you first
may develop heat cramps. If you don't cool down, you
may progress to symptoms of heat exhaustion, such as
heavy sweating, nausea, lightheadedness and feeling
faint.
Heatstroke occurs if your body temperature continues
to rise. At this point, emergency treatment is needed. In
a period of hours, untreated heatstroke can cause
damage to your brain, heart, kidneys and muscles.
These injuries get worse the longer treatment is
delayed, increasing your risk of serious complications or
death.
Symptoms
By Mayo Clinic Staff
Heatstroke symptoms include:
High body temperature. A body
temperature of 104 F (40 C) or higher is the
main sign of heatstroke.
A lack of sweating. In heatstroke brought on
by hot weather, your skin will feel hot and dry
to the touch. However, in heatstroke brought
on by strenuous exercise, your skin may feel
moist.
Nausea and vomiting. You may feel sick to
your stomach or vomit.
Flushed skin. Your skin may turn red as your
body temperature increases.
Rapid breathing. Your breathing may
become rapid and shallow.
Racing heart rate. Your pulse may
significantly increase because heat stress places
a tremendous burden on your heart to help
cool your body.
Headache. You may experience a throbbing
headache.
Confusion. You may have seizures,
hallucinate, or have difficulty speaking or
understanding what others are saying.
Unconsciousness. You may pass out or fall
into a state of deep unconsciousness (coma).
Muscle cramps or weakness. Your muscles
may feel tender or cramped in the early stages
of heatstroke, but may later go rigid or limp.

Heatstroke follows two less serious heat-
related conditions:
Heat cramps. Heat cramps are caused by
initial exposure to high temperatures or
physical exertion. Signs and symptoms of heat
cramps usually include excess sweating, fatigue,
thirst and cramps, usually in the stomach, arms
or legs. This condition is common in very hot
weather or with moderate to heavy physical
activity. You can usually treat heat cramps by
drinking water or fluids containing electrolytes
(Gatorade or other sports drinks), resting and
getting to a cool spot, like a shaded or air-
conditioned area.

Heat exhaustion. Heat exhaustion occurs
when you don't act on the signs and symptoms
of heat cramps and your condition worsens.
Signs and symptoms of heat exhaustion include
a headache, dizziness or lightheadedness,
nausea, skin that feels cool and moist, and
muscle cramps. Often with heat exhaustion, you
can treat the condition yourself by following the
same measures used to treat heat cramps, such
as drinking cool, nonalcoholic beverages,
getting into an air-conditioned area or taking a
cool shower. If your symptoms persist, seek
medical attention immediately.
When to see a doctor
If you think a person may be experiencing
heatstroke, seek immediate medical help. Call
911 or your local emergency services number.
Take immediate action to cool the overheated
person while waiting for emergency treatment.
Help the person move to a shaded location and
remove excess clothing.
Place ice packs or cold, wet towels on the
person's head, neck, armpits and groin.
Mist the person with water while a fan is
blowing on him or her.
Causes
By Mayo Clinic Staff
Heatstroke can occur in these ways:
Exposure to a hot environment. In a type of
heatstroke called nonexertional heatstroke,
your condition is caused by a hot environment
that leads to a rise in body temperature,
without strenuous physical activity. This type of
heatstroke typically occurs in hot, humid
weather, especially for prolonged periods. It
occurs most often in older adults and in people
with chronic illness.
Strenuous activity. In a type of heatstroke
called exertional heatstroke, your condition is
caused by an increase in body temperature
brought on by physical activity in hot weather.
Anyone exercising or working in hot weather
can get exertional heatstroke, but it's most
likely to occur if you're not accustomed to high
temperatures.
In either type of heatstroke, your condition can
be brought on by:
Wearing excess clothing that prevents your
sweat from evaporating easily and cooling your
body
Drinking alcohol, which can affect your body's
ability to regulate your temperature
Becoming dehydrated, because you're not
drinking enough water to replenish fluids you
lose through perspiration

Complications
By Mayo Clinic Staff
A possible complication of heatstroke is shock,
which is a condition caused by a sudden loss of
blood flow. Signs of shock include a very low
blood pressure, blue lips and nails, and cool,
clammy skin.
If you or others don't act quickly on the
symptoms of heatstroke, you could die or
experience damage to your brain or other vital
organs. In response to heatstroke, these organs
swell, and if you don't cool your body
temperature quickly, the damage from this
swelling could be permanent.
Tests and diagnosis
By Mayo Clinic Staff
It's usually apparent to doctors if you have heatstroke,
but they may order laboratory tests to confirm their
diagnosis and rule out other causes of your symptoms.
These tests include:
A blood test to check for low blood sodium or
potassium and the content of gases in your
blood to see if there's been any damage to your
central nervous system
A urine test to check the color of your urine,
because it's usually darker if you have a heat-
related condition, and to check your kidney
function, which can be affected by heatstroke
Muscle function tests to check for
rhabdomyolysis serious damage to your
muscle tissue
X-rays and other imaging tests to check for
damage to your internal organs

Treatments and drugs
By Mayo Clinic Staff
Heatstroke treatment centers on cooling your
body to a normal temperature to prevent or
reduce damage to your brain and vital organs.
To do this, your doctor may take these steps:
Immerse you in cold water. Your doctor may
put your body in a bath of cold water or ice
water to quickly lower your temperature.
Use evaporation cooling techniques. Some
doctors prefer to use evaporation instead of
immersion to lower your body temperature. In
this technique, cool water is misted on your skin
while warm air fanned over your body causes
the water to evaporate, cooling the skin.
Pack you with ice and cooling
blankets. Another method is to wrap you in a
special cooling blanket and apply ice packs to
your groin, neck, back and armpits to lower
your temperature.
Give you medications to stop your shivering. If
any treatments to lower your body temperature
make you shiver, your doctor may give you a
muscle relaxant, such as a benzodiazepine.
Shivering increases your body temperature,
making treatment less effective.
Lifestyle and home
remedies
By Mayo Clinic Staff
Home treatment isn't sufficient treatment for
heatstroke. If you have signs or symptoms of
heatstroke, seek emergency medical help. Others
should take steps to cool you off while waiting for
emergency help to arrive.
If you notice signs of heat-related illness before any
noticeable signs or symptoms of heatstroke appear,
take action to lower your body temperature and
prevent your condition from progressing to heatstroke.
In a lesser heat emergency, such as heat cramps or heat
exhaustion, the following steps may be sufficient to
lower your body temperature:
Get to a shady or air-conditioned
place. Remaining in the heat will worsen your
condition. If you don't have air conditioning at
home, go someplace that is air-conditioned,
such as the mall, movie theatre or public library.
Cool off with damp sheets and a fan. If you're
with someone who's experiencing heat-related
symptoms, cool the person by covering him or
her with damp sheets or by spraying with cool
water. Direct air onto the person with a fan.
Take a cool shower or bath. If you're outdoors
and nowhere near shelter, soaking in a cool
pond or stream also can help bring your
temperature down.
Rehydrate. Keep in mind that the symptoms of
heat-related illnesses are caused not only when
you become dehydrated but also when you lose
salt through sweating. Some sports drinks will
replenish both water and salt. The amount
you'll need to drink to rehydrate varies from
person to person, so sip slowly and call your
doctor if you're concerned. And, if you're on a
low-sodium diet, be sure to check with your
doctor before having drinks with a high salt
content.
Don't drink beverages with alcohol to
rehydrate. These drinks may interfere with your
body's ability to control your temperature.
Prevention
By Mayo Clinic Staff
Heatstroke is predictable and preventable.
Take these steps to prevent heatstroke during
hot weather:
Wear loosefitting, lightweight
clothing. Wearing excess clothing or clothing
that fits tightly won't allow your body to cool
properly.
Wear light-colored clothing if you're in the
sun. Dark clothing absorbs heat. Light-colored
clothing can help keep you cool by reflecting
the sun's rays.
Drink plenty of fluids. Staying hydrated will
help your body sweat and maintain a normal
body temperature.
Take extra precautions with certain
medications. Be on the lookout for heat-related
problems if you take medications that can
affect your body's ability to stay hydrated and
dissipate heat.
Never leave children or anyone else in a
parked car. This is a common cause of heat-
related deaths in children. When parked in the
sun, the temperature in your car can rise 20
degrees F (more than 6.7 C) in just 10 minutes.
It's not safe to leave a person inside a parked
car in hot weather for any period of time, even
if the windows are cracked or the car is in the
shade. When your car is parked, keep it locked
to prevent a child from getting inside.
Take it easy during the hottest parts of the
day. If you can't avoid strenuous activity in hot
weather, follow the same precautions and rest
frequently in a cool spot. Try to schedule
exercise or physical labor for cooler parts of the
day, such as early morning or evening. Taking
breaks and replenishing your fluids during that
time will help your body regulate your
temperature.
Get acclimatized. Limit the amount you spend
working or exercising in the heat until you're
conditioned to it. People who are not used to
hot weather are especially susceptible to heat-
related illness, including heatstroke. It can take
several weeks for your body to adjust to hot
weather.
Be cautious if you're at increased risk. If you
take medications or have a physical condition
that increases your risk of heat-related
problems, avoid the heat and act quickly if you
notice symptoms of overheating. If you
participate in a strenuous sporting event or
activity in hot weather, make sure there are
medical services at the event in case a heat
emergency arises.

Heat Stroke
(Sunstroke, Heat Exhaustion, Thermic Fever, Siriasis)
The Facts on Heat Stroke
Heat stroke is also known as sunstroke, thermic fever, or
siriasis. It happens when the body's mechanisms for
controlling temperature fail. Heat stroke is a life-threatening
emergency needing immediate treatment. While many people
feel sick and faint during heat waves, most of these people are
suffering from heat exhaustion, a related condition usually less
serious than heat stroke.
There are two types of heat stroke: classic, non-exertional heat
stroke (NEHS) and exertional heat stroke (EHS). Classic heat
stroke occurs most commonly in very young or older
individuals, who have health risks and are in poor
environmental conditions. Exertional heat stroke occurs more
often in younger, healthy individuals who participate in
strenuous physical activity.
Causes of Heat Stroke
Working or exercising in hot conditions or weather
without drinking enough fluids is the main cause of heat
stroke. You can get heat stroke by not replacing lost fluids
over days or weeks, or you can bring it on in a few hours by
exercising strenuously on a hot day without drinking plenty of
liquids first.
Liquids help to cool us down by allowing the body to produce
sweat. However, liquids are also necessary for bodily
functions, such as keeping up blood pressure. You can lose
large amounts of body fluid in the form of sweat without
noticing any effects, but at a certain point the body will reserve
the remaining fluid for vital functions and stop sweating. The
body's core temperature then shoots up, and cells start dying.
Sweat evaporates more rapidly in dry weather, cooling the
body more efficiently than in humid weather. When working in
humid conditions, the core temperature rises more rapidly. This
is why weather forecasts add a humidity factor or heat index to
represent how you will actually feel outdoors.
People with the following conditions are especially prone
to heat stroke:
alcoholism
chronic illnesses like heart disease
obesity
older age
Parkinson's disease
uncontrolled diabetes
use of certain medications such as diuretics and
antihistamines
use of some psychoactive drugs such as alcohol and
cocaine
Heavy clothing and some skin conditions can also contribute to
the occurrence of heat stroke.
Symptoms and Complications of Heat Stroke
The symptoms of heat stroke are quite different from those of
heat exhaustion.
Symptoms of heat exhaustion:
moderately high core temperature (the temperature of
the body's internal organs, best measured with a
rectal thermometer) of up to 39C (102F)
cool, pale, clammy skin
muscle cramps
headache
nausea
fatigue and weakness
dizziness or lightheadedness
possible fainting, but can be revived
A person suffering from heat exhaustion will usually be
sweating profusely in an attempt to get rid of excess heat.
Symptoms of heat stroke:
extremely high core temperature of up to 41C
(106F)
hot, red, dry skin
rapid pulse
rapid, shallow breathing
headache
confusion, strange behaviour
possible loss of consciousness
Someone with heat stroke has stopped sweating, due to a
failure in his or her heat control system.
High core temperatures damage the internal organs, especially
the brain. The fluid loss can also produce dangerously low
blood pressure. Most people who are killed by heat stroke die
when their heart stops pumping effectively (circulatory failure).
Even people who survive are likely to have permanent brain
damage if their core temperature has been over
40.6C (105F) for more than an hour or two.