Common Misconceptions in Classic and Exertional Heat Stroke

Abstract

Heat stroke is the most severe manifestation of heat illness. Classic heat stroke (CHS) is defined as central nervous system (CNS) dysfunction and severe hyperthermia as a consequence of heat exposure at rest and affects mostly vulnerable populations (i.e., elderly during heat waves and/or children left in vehicles). Exertional heat stroke (EHS) shares a similar definition as CHS, except it is triggered in young, otherwise healthy individuals during physical exertion in a hot or temperate environment. CHS and EHS have long been a topic of interest in physiology and have been extensively studied; yet, there are many misconceptions regarding the impact of heat on organ systems as well as the etiology that predisposes certain individuals to collapse. This chapter discusses five misconceptions that have skewed our understanding of heat stroke pathophysiology, mainly due to misinterpretation of data, conjecture that has become dogma as well as limitations in the approaches to study the condition.