Heat stroke classification

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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

On the basis of temperature, heat stroke must be differentiated from heat wave, heat stress, heat exhaustion, hyperthermia and multi-organ dysfunction syndrome. Heat stroke is classified to 2 types: Exertional heat stroke (EHS) generally occurs in young individuals who engage in strenuous physical activity for a prolonged period in a hot environment and classic nonexertional heat stroke (NEHS) more commonly affects sedentary elderly individuals, persons who are chronically ill, and very young persons.[1]

Classification

Heat related problems may be classified based on the temperature and the clinical presentation. The following table summarizes the related terms.[1][2]

Condition Definition
Heat wave Three or more consecutive days during which the air temperature is >32.2°C.
Heat stress Perceived discomfort and physiological strain associated with exposure to a hot environment, especially during physical work.
Heat stroke Severe illness characterized by a core temperature >40°C and central nervous system abnormalities such as delirium, convulsions,

or coma resulting from exposure to environmental heat (classic heat stroke) or strenuous physical exercise (exertional heat stroke).

Heat exhaustion Mild-to-moderate illness due to water or salt depletion that results from exposure to high environmental heat or strenuous physical

exercise; signs and symptoms include intense thirst, weakness, discomfort, anxiety, dizziness, fainting, and headache; core temperature

may be normal, below normal, or slightly elevated (>37°C but <40°C).

Hyperthermia A rise in body temperature above the hypothalamic set point when heat-dissipating mechanisms are impaired (by drugs or disease) or

overwhelmed by external (environmental or induced) or internal (metabolic) heat.

Multiorgan-dysfunction

syndrome

Continuum of changes that occur in more than one organ system after an insult such as trauma, sepsis, or heat stroke.

Heat stroke is classified to 2 types.

  • Exertional heat stroke (EHS) generally occurs in young individuals who engage in strenuous physical activity for a prolonged period in a hot environment.
  • Classic nonexertional heat stroke (NEHS) more commonly affects sedentary elderly individuals, persons who are chronically ill, and very young persons.[1]

References

  1. 1.0 1.1 Leon LR, Bouchama A (2015). "Heat stroke". Compr Physiol. 5 (2): 611–47. doi:10.1002/cphy.c140017. PMID 25880507.
  2. Bouchama A, Knochel JP (2002). "Heat stroke". N. Engl. J. Med. 346 (25): 1978–88. doi:10.1056/NEJMra011089. PMID 12075060.
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