Journal
NEW ENGLAND JOURNAL OF MEDICINE
Volume 380, Issue 25, Pages 2449-2459Publisher
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMra1810762
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Heatstroke is a syndrome consisting of life-threatening central nervous system and multiple organ dysfunction from complications of hyperthermia. Additionally, there is an associated complex immunological and inflammatory component to the illness that resembles sepsis. Core body temperature exceeds 40 degrees C with associated mental status changes such as delirium and coma. Generalized tonic/clonic seizures can occur. A variable degree of organ involvement is present that contributes to the severity of the medical picture. Heatstroke can be viewed as a tropical neurological disorder especially for unacclimated travelers going to warm climates. Heatstroke can be categorized into two types depending on the cause. Classic heatstroke is nonexertional, environmentally related and exertional heatstroke occurs in the setting of strenuous exercise. Heatstroke is actually the most severe of a continuum of heat-related illnesses that carries a high incidence of mortality. Treatment is directed at rapidly reducing core body temperature and the management of life-threatening systemic complications.
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