Exertional Heat Stroke in Athletes

Abstract

Exercising in hot and especially humid environment can cause rise in body core temperature to such a critical level that it does not only reduce performance, but also may ultimately lead to exertional heat stroke (EHS). This illness is true medical emergency that can result in significant morbidity and mortality, if not early recognized and promptly treated. Diagnostic criteria for EHS are body core temperature above 40ºC and central nerve system dysfunction. Any athlete experiencing such symptoms should be immediately exposed to aggressive cooling treatment aimed to lower the elevated core temperature to near normal as quickly as possible. Ice water immersion is highly recommended as a cooling method because it provides the fastest cooling rates and is associated with lowest mortality rates. Athletes cooled rapidly soon after the onset of EHS usually recover without complications and are able to return to normal training in hot environment within a few weeks. EHS is also a preventable condition, and its occurrence can be minimized by implementing a few simple measures.

Hot water immersion as a potential substitute for strength training during the COVID-19 pandemic

“…Furthermore, the risk of heat stroke associated with immersion in 40 °C water (Lee et al, 2010) is reduced with the proposed protocol because this protocol is expected to limit the increase in core temperature to ~39 °C. This value of core temperature is lower than that (>40 °C) observed after the onset of heat stroke (Epstein and Yanovich, 2019;Kjertakov and Epstein, 2013). Nevertheless, the treatment should be terminated in the case of an onset of nausea, dizziness, or unbearable discomfort.…”

Hot water immersion could be an effective alternative to physical exercise in improving cardiovascular fitness during the COVID-19 pandemic

“…Theoretically, the risk for heat stroke associated with the hot water immersion treatment described by Bailey et al (2016) previously in the text is low because this treatment induces an increase in body core temperature no higher than 38 °C. The onset of heat stroke is associated with core temperatures above 40 °C (Costrini et al, 1979;Aarseth et al, 1986;Epstein et al, 1995;Kjertakov and Epstein, 2013). Available evidence indicates that hot water immersion is generally only contraindicated in people with epilepsy, as in some of this population hot bathing can provoke seizures (Stensman and Ursing, 1971;Satishchandra et al, 1988;Bebek 2001;Yalçın et al, 2006).…”