Heat stroke in adults

Case history #1

An 83-year-old bedridden man presents to the accident and emergency department after being found unresponsive in his home. His medical history includes hypertension, and schizophrenia treated with antipsychotics. At the time of presentation, the city has experienced >6 days of temperature highs ≥34°C. The patient lives on an upper floor of a block of flats that has no air conditioner and poor ventilation, and lives alone with neighbours and family members looking in on him only intermittently. On evaluation, he is found to have a core temperature of 42°C.

Case history #2

A 23-year-old woman is brought to the medical tent after collapsing during a 10 km road race. The race start was delayed, and the ambient temperature at the time of starting was 37°C, with 90% humidity. The woman had travelled to take part in the race from her home, which was much cooler than the city in which the race took place. At the time of her collapse, she was found to be hypotensive and tachycardic. Rectal temperature was elevated at 41°C. She was initially combative and declined care, insisting that she would walk to her home 1000 km away instead of submitting to care by the race physicians.

Other presentations