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Exertional Heat Stroke

A life-threatening emergency in which thermoregulation fails during intense exercise and the body temperature rises above 40°C.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Exertional Heat Stroke?

Exertional heat stroke is the rise of core body temperature above 40°C and the appearance of central nervous system dysfunction when endogenous heat production combines with environmental conditions during intense physical activity.

Unlike classic (elderly, passive) heat stroke, it occurs in young, healthy individuals. Rhabdomyolysis, acute kidney injury and DIC may develop.

Early recognition and rapid on-site cooling (ice water immersion) are critical. Mortality increases with each passing minute; the goal is to lower the temperature below 39°C within the first 30 minutes.

Symptoms

Rectal temperature >40°C
Confusion, agitation, seizure
Sweating (characteristically may still be present)
Tachycardia, hypotension
Rhabdomyolysis (brown urine)
Acute kidney injury
Coagulopathy

Risk Factors

High temperature and humidity
Unaccustomed (lack of acclimatization) exercise
Dehydration
Inappropriate clothing
Use of stimulant or anticholinergic drugs
Obesity and lack of conditioning
Prior heat stroke history

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Call 112 immediately if collapse and confusion occur during exercise
  • A rectal temperature above 40°C is an emergency; start cooling without delay
  • Do not waste time in seizures or prolonged confusion
  • If brown urine appears, suspect rhabdomyolysis and go to hospital

Treatment Methods

01
Stop activity and move to shade/cool environment
02
On-site ice water immersion or wet sheet plus fan cooling
03
Cooling until target rectal temperature is below 39°C
04
IV fluid resuscitation
05
Maintenance of urine output for rhabdomyolysis
06
Electrolyte, coagulation and renal monitoring
07
Antipyretics are ineffective and not recommended
08
Intensive care monitoring

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.