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Killer Heat - Pathology of Heatstroke (Infographic)

 Dr  Sampurna Roy  MD 

 

India is reeling under severe heat wave. More than 1100 people have died due to heatstroke.

This infographic highlights some important facts about pathology and pathogenesis of this serious environmental disorder.

 

  Killer Heat - Pathology of Heatstroke

 

Heatstroke is a serious syndrome most commonly seen in tropics and during heat waves in subtropics.

Important environmental risk factors are hot temperature, high humidity, poor working and living conditions.

Those working under direct sunlight or living in poorly insulated houses in megacities are vulnerable to heatstroke.

 

Pathology and pathogenesis:

When the external atmosphere is extremely hot and humid. 

- There is marked rise in body temperature.

- The heat regulating centre becomes depressed and temperature further rises.

- This increases the metabolic rate so the vicious circle is established, and the temperature rises to 41deg C or more.

 THIS IS HEATSTROKE OR SUNSTROKE

 

 
- If patient is not immediately treated the temperature may continue to rise reaching 43 deg C or more, a level at which the patient becomes comatose.

 

  

- Cerebral, hepatic and renal damage are prominent.

- Convulsions are common and permanent brain damage may be evident if the patient survives.

 

 
Small children, elderly people (above 65 years of age),  labourers and construction workers exposed to hot, humid environments are vulnerable to heatstroke.

Heatstroke occurs in healthy persons who exert themselves with such intensity that the heat produced by skeletal muscles cannot be dissipated quickly enough to cool the body.

                          

 

Other factors that predispose people to heatstroke include alcoholism, skin disease or injury that impairs or prevents sweating, cardiovascular disease, general debility, co-existence of a febrile disorder, dehydration, obesity and certain drugs.

 

Autopsy findings in heatstroke deaths are nonspecific and depend on survival duration after exposure.

The diagnosis of hyperthermia is therefore essentially based on scene investigation, the circumstances of death, and the reasonable exclusion of other causes of death.

 
Some simple advice for those working under intense heat:

 

1) Drink large quantities of cool water and fruit juice.

2) Stay indoors in the afternoon and take plenty of rest.

3) Wear loose clothes, cover your head with umbrella, cap or atleast a piece of wet cloth.

4) If you are a labourer give yourself a break from intense work. Take rest under the shade of the trees and keep yourself hydrated.

5) If you are a car driver don't sit inside a parked car. Wait in a cool place for your employer.

6) Take regular cold showers, before and after work.

7) Let your body adjust to extreme temperature change if you are suddenly moving from hot to cold temperature or vice versa. Example :Vacation to a hill station or working in a air conditioned office.

8) Consult you local physician immediately if you feel unwell.

 

Dr Sampurna Roy MD

 

Further reading:

Diagnostic value of coagulation factor and intracranial pressure monitoring in acute liver failure from heat stroke: case report and review of the literature.

Cytokines and their role in hyperthermia and heat stroke.

The actions of hyperthermia on the autonomic nervous system: central and peripheral mechanisms and clinical implications.

Hyperthermia and postmortem biochemical investigations.

 

 

Dr  Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

 

          

 

 

 

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