Heat Stroke

What are the signs and symptoms of heat stroke?

Heat stroke signs and symptoms include:

• High internal (core) body temperature, typically over 104 degrees Fahrenheit (40 degrees Celsius).
• Behavior changes — like agitation or aggression.
• Blurred vision.
• Confusion.
• Delirium.
• Dizziness.
• Fainting (syncope).
• Fast heart rate (tachycardia).
• Fast, shallow breathing (tachypnea).
• Low blood pressure (hypotension).
• Nausea and vomiting.
• Seizures.
• Slurred speech.
• Skin color changes — either flushed or paler than usual.
• Skin that’s dry (classic heat stroke) or sweaty (exertional heat stroke).
• Weakness.

Some of these signs and symptoms you may notice in yourself — and if you do, you should call 911 or your local emergency service number immediately. But if you’re confused or you lose consciousness, you’ll need someone else to seek medical help for you. That’s why learning the symptoms of heat stroke is so important. Bystanders are often crucial for noticing something isn’t right and alerting medical professionals.

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What does heat stroke feel like?

Heat stroke involves physical symptoms like nausea, vomiting and dizziness. But it can also cause more than physical discomfort. You may feel confused or have trouble thinking clearly. Others may notice you’re not acting like your usual self. That’s because heat stroke (unlike milder forms of heat illness) affects your brain function, causing changes in your thinking and behavior.

What causes heat stroke?

Heat stroke happens when excess heat overwhelms your body’s built-in system for cooling itself. Excess heat can come from:

• Outside your body. This is environmental heat. Think of the hot, humid air that surrounds you on a summer’s day or the warm, stuffy air in an enclosed room.
• Inside your body. This is heat your metabolism generates during physical activity. It’s what you might call internal body heat.

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These can occur at the same time. For example, you might go for a run on a hot day.

Normally, your body can get rid of excess heat — primarily through sweating — and restore a normal body temperature. When sweat evaporates from your skin, it cools your skin and the tissues underneath. This process is vital to thermoregulation, or your body’s ability to maintain a constant internal temperature that’s not too hot or too cold.

But if the air around you is very hot or your metabolism generates lots of heat, your body may struggle to keep up. Just like extreme heat can strain your home’s A/C unit, it can also overtax your body’s natural cooling system, leading to heat stroke.

What are the risk factors for developing heat stroke?

Heat stroke risk factors fall into several categories:

• Jobs and activities. Agricultural workers, construction workers, firefighters, military members and athletes face an increased risk of heat stroke. Casual workouts can also lead to heat stroke, especially if you’re not used to physical activity in the heat.
• Social and environmental factors. These are things like not having air conditioning at home, living in a warm climate, living alone and feeling pressure from friends or coaches to push your body to its limits.
• Age and health conditions. You face a higher risk of heat stroke if you’re over age 65, pregnant, dehydrated, have a viral or bacterial infection or have cardiovascular disease (which can affect your body’s ability to cool down). Conditions that limit your body’s ability to sweat — putting you at risk for overheating — include anhidrosis, deep burns, extensive scars and ectodermal dysplasia (an inherited condition that can affect your sweat glands).
• Medications and substances. Certain medications and substances interfere with your body’s ability to cool down. They might raise your risk of dehydration, reduce how much you sweat or cause your metabolism to generate more heat. More information is below.

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Babies and children also face an increased risk of heat stroke. They’re vulnerable to extreme heat, even for short periods of time. This is why it’s dangerous to leave your child in an enclosed car, no matter how soon you think you’ll be back.

Medications and substances that raise your risk of heat stroke

Medications:

• Amphetamines.
• Anticholinergics, which are medications that block acetylcholine — a chemical that stimulates sweat production.
• Antihistamines.
• Antipsychotic medications.
• Benzodiazepines.
• Beta-blockers.
• Calcium-channel blockers.
• Diuretics.
• Laxatives.
• Lithium (a mood stabilizer).
• Selective serotonin reuptake inhibitors (SSRIs).
• Tricyclic antidepressants.

Other substances:

• Alcohol.
• Cocaine.
• Heroin.
• Phencyclidine (PCP).
• MDMA (“ecstasy”).

These lists aren’t exhaustive. Ask your healthcare provider if any medications or substances you’re using raise your risk for heat-related illness.

What are possible complications of heat stroke?

Serious complications that can occur with heat stroke include:

• Disruption to your brain activity (coma).
• Muscle breakdown, which sends toxins into your blood (rhabdomyolysis).
• Reduced flow of blood and oxygen to your organs (hypovolemic shock).
• Severe damage to major organs like your lungs (acute respiratory distress syndrome), kidneys (kidney failure), heart (heart failure) or liver (liver failure).

Because heat stroke can lead to life-threatening complications, every minute counts when it comes to getting medical care.

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