Heatstroke is an extreme form of heat-related illness that commonly affects many organ systems. Notably, abnormalities may be evident in the central nervous, respiratory, cardiovascular, hepatic, gastrointestinal and renal systems. Coagulopathy is common.
A central defining feature is a core body temperature >40oC, associated with central nervous system dysfunction (such as confusion, seizures, or impaired consciousness).
Morbidity and mortality (which can be in excess of 50% in those of advanced age) are high, especially in those requiring critical care support with a high incidence of long-term health complications.
Risk factors differ significantly between the two types of heatstroke: classical and exertional. These are contrasted in the table below.
Table 1. Risk factors for classical and exertional heatstroke
|
CLASSICAL
|
EXERTIONAL
|
|
Social
-
Isolation
-
Poor ventilation
-
Dependent on care
-
Bedbound
|
Social
|
|
Physiological
-
Cardiac dysfunction
-
Impaired vasodilatation
-
Impaired sweating
-
Dehydration
|
Physiological
|
|
Pharmacological
|
Pharmacological
-
Alcohol
-
Amphetamines
-
Cocaine
-
MDMA (ecstasy)
-
Synthetic stimulants
|
|
Environmental
|
Environmental
|
|
Health-related
-
Extremes of age
-
Male sex
-
Cardiovascular disease
-
Cerebrovascular disease
-
Diabetes mellitus
-
Mental health disease
-
Respiratory disease
|
Health-related
-
Existing infection
-
Sweat-gland dysfunction
|
