Symptoms and causes

Heatstroke signs and symptoms include:

  • High body temperature. A core body temperature of 104 F (40 C) or higher, obtained with a rectal thermometer, is the main sign of heatstroke.
  • Altered mental state or behavior. Confusion, agitation, slurred speech, irritability, delirium, seizures and coma can all result from heatstroke.
  • Alteration in sweating. In heatstroke brought on by hot weather, your skin will feel hot and dry to the touch. However, in heatstroke brought on by strenuous exercise, your skin may feel dry or slightly moist.
  • Nausea and vomiting. You may feel sick to your stomach or vomit.
  • Flushed skin. Your skin may turn red as your body temperature increases.
  • Rapid breathing. Your breathing may become rapid and shallow.
  • Racing heart rate. Your pulse may significantly increase because heat stress places a tremendous burden on your heart to help cool your body.
  • Headache. Your head may throb.

Heatstroke can occur as a result of:

  • Exposure to a hot environment. In a type of heatstroke, called nonexertional (classic) heatstroke, being in a hot environment leads to a rise in core body temperature. This type of heatstroke typically occurs after exposure to hot, humid weather, especially for prolonged periods. It occurs most often in older adults and in people with chronic illness.
  • Strenuous activity. Exertional heatstroke is caused by an increase in core body temperature brought on by intense physical activity in hot weather. Anyone exercising or working in hot weather can get exertional heatstroke, but it's most likely to occur if you're not used to high temperatures.

In either type of heatstroke, your condition can be brought on by:

  • Wearing excess clothing that prevents sweat from evaporating easily and cooling your body
  • Drinking alcohol, which can affect your body's ability to regulate your temperature
  • Becoming dehydrated by not drinking enough water to replenish fluids lost through sweating

Anyone can develop heatstroke, but several factors increase your risk:

  • Age. Your ability to cope with extreme heat depends on the strength of your central nervous system. In the very young, the central nervous system is not fully developed, and in adults over 65, the central nervous system begins to deteriorate, which makes your body less able to cope with changes in body temperature. Both age groups usually have difficulty remaining hydrated, which also increases risk.
  • Exertion in hot weather. Military training and participating in sports, such as football or long-distance running events, in hot weather are among the situations that can lead to heatstroke.
  • Sudden exposure to hot weather. You may be more susceptible to heat-related illness if you're exposed to a sudden increase in temperature, such as during an early-summer heat wave or travel to a hotter climate. Limit activity for at least several days to allow yourself to acclimate to the change. However, you may still have an increased risk of heatstroke until you've experienced several weeks of higher temperatures.
  • A lack of air conditioning. Fans may make you feel better, but during sustained hot weather, air conditioning is the most effective way to cool down and lower humidity.
  • Certain medications. Some medications affect your body's ability to stay hydrated and respond to heat. Be especially careful in hot weather if you take medications that narrow your blood vessels (vasoconstrictors), regulate your blood pressure by blocking adrenaline (beta blockers), rid your body of sodium and water (diuretics), or reduce psychiatric symptoms (antidepressants or antipsychotics).

    Stimulants for attention-deficit/hyperactivity disorder (ADHD) and illegal stimulants such as amphetamines and cocaine also make you more vulnerable to heatstroke.

  • Certain health conditions. Certain chronic illnesses, such as heart or lung disease, might increase your risk of heatstroke. So can being obese, being sedentary and having a history of previous heatstroke.

Heatstroke can result in a number of complications, depending on how long the body temperature is high. Severe complications include:

  • Vital organ damage. Without a quick response to lower body temperature, heatstroke can cause your brain or other vital organs to swell, possibly resulting in permanent damage.
  • Death. Without prompt and adequate treatment, heatstroke can be fatal.
Aug. 15, 2017
References
  1. Heat stress-heat related illness. Centers for Disease Control and Prevention. https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html. Accessed June 15, 2017.
  2. Extreme heat. Ready Campaign. https://www.ready.gov/heat. Accessed June 15, 2017.
  3. O'Connor FG, et al. Exertional heat illness in adolescents and adults: Epidemiology, thermoregulation, risk factors, and diagnosis. https://www.uptodate.com/contents/search. Accessed June 15, 2017.
  4. Mechem CC. Severe nonexertional hyperthermia (classic heat stroke) in adults. https://www.uptodate.com/contents/search. Accessed June 15, 2017.
  5. Extreme heat: A prevention guide to promote your personal health and safety. Centers for Disease Control and Prevention. https://www.cdc.gov/disasters/extremeheat/heat_guide.html. Accessed June 15, 2017.
  6. Ferri FF. Heat exhaustion and heat stroke. In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed June 15, 2017.
  7. Laskowski ER (expert opinion). Mayo Clinic, Rochester, Minn. June 19, 2017.