We discussed a case of an elderly woman who presented with fever (up to 39.4C), hypotension, acute encephalopathy, due to heat stroke.

Diagnosis

• Core temp > 40C (104F) + CNS dysfunction + exposure to severe environmental heat

Types

• Exertional vs Nonexertional

Complications

• Pulm (aspiration, bronchospasm, noncardiogenic pulm edema, ARDS)
• Cardiac (hypotension, arrhythmias)
• MSK (rhabdomyolysis)
• GI (hepatic injury)
• Renal (AKI / renal failure)
• Neuro (seizures, cerebral edema)
• Heme (DIC)

Treatment

• ABCs!
• Rapid cooling via evaporative and convective methods (spray water + fan)
• Fluid resuscitation
• Pharmacologic therapies (eg acetaminophen, dantrolene) are NOT effective