Heat stroke 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

If heat stroke left untreated it may result in severe complications and even death. its complications include: multiple organ failure, acute renal failure, myocardial injury and even DIC. Timely resuscitation and fluid replacement decreases the mortality and can prevent sustained brain injury, which is the most important prognostic factor.

Natural History

Heat stroke presents with altered mental status and signs of dehydration. Its symptoms develop in a susceptible person who did excessive exercise in hot weather. If left untreated it may result in severe complications and eventually death.

Complications

The complications of heat stroke include:^[1]^[2]

Life Threatening complications

Syndrome of multiorgan dysfunction
Acute renal failure
Myocardial injury
Disseminated intravascular coagulation (DIC)

Common Complications

Dehydration
Electrolyte disturbances
Encephalopathy
Anterograde amnesia
Acute respiratory distress syndrome
Hepatocellular damage
Rhabdomyolysis
Acute renal failure
Myocardial injury
Hematologic complications
- Disseminated intravascular coagulation (DIC)
- Thrombocytopenia

Rare Complications

The rare complications include:^[1]^[2]

Bowel ischemia or infarction
Pancreatic injury

Prognosis

The revival of the functioning of the central nervous system is a positive prognostic sign. It is usually seen following aggressive therapy. 20% patients face residual damage of the brain and a higher mortality is associated with this.^[3]^[4]

References

↑ ^1.0 ^1.1 Masood U, Sharma A, Syed W, Manocha D (2016). "Bowel Ischemia from Heat Stroke: A Rare Presentation of an Uncommon Complication". Case Rep Med. 2016: 5217690. doi:10.1155/2016/5217690. PMC 5093235. PMID 27840645.
↑ ^2.0 ^2.1 al-Mashhadani SA, Gader AG, al Harthi SS, Kangav D, Shaheen FA, Bogus F (1994). "The coagulopathy of heat stroke: alterations in coagulation and fibrinolysis in heat stroke patients during the pilgrimage (Haj) to Makkah". Blood Coagul Fibrinolysis. 5 (5): 731–6. PMID 7865679.
↑ Hart GR, Anderson RJ, Crumpler CP, Shulkin A, Reed G, Knochel JP (1982). "Epidemic classical heat stroke: clinical characteristics and course of 28 patients". Medicine (Baltimore). 61 (3): 189–97. PMID 7078400.
↑ Dematte JE, O'Mara K, Buescher J, Whitney CG, Forsythe S, McNamee T; et al. (1998). "Near-fatal heat stroke during the 1995 heat wave in Chicago". Ann Intern Med. 129 (3): 173–81. PMID 9696724.

[pmid27840645-1] 1.0 ^1.1 Masood U, Sharma A, Syed W, Manocha D (2016). "Bowel Ischemia from Heat Stroke: A Rare Presentation of an Uncommon Complication". Case Rep Med. 2016: 5217690. doi:10.1155/2016/5217690. PMC 5093235. PMID 27840645.

[pmid7865679-2] 2.0 ^2.1 al-Mashhadani SA, Gader AG, al Harthi SS, Kangav D, Shaheen FA, Bogus F (1994). "The coagulopathy of heat stroke: alterations in coagulation and fibrinolysis in heat stroke patients during the pilgrimage (Haj) to Makkah". Blood Coagul Fibrinolysis. 5 (5): 731–6. PMID 7865679.

[pmid7078400-3] Hart GR, Anderson RJ, Crumpler CP, Shulkin A, Reed G, Knochel JP (1982). "Epidemic classical heat stroke: clinical characteristics and course of 28 patients". Medicine (Baltimore). 61 (3): 189–97. PMID 7078400.

[pmid9696724-4] Dematte JE, O'Mara K, Buescher J, Whitney CG, Forsythe S, McNamee T; et al. (1998). "Near-fatal heat stroke during the 1995 heat wave in Chicago". Ann Intern Med. 129 (3): 173–81. PMID 9696724.

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