A case of severe heat stroke with abnormal cardiac findings

Shu Wakino, Shingo Hori, Takuya Mimura, Satoru Miyatake, Seitaroh Fujishima, Naoki Aikawa

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

We document serial changes in the electrocardiogram (ECG) and myocardial markers in a case of severe heat stroke treated with cooling procedures. A 23-year-old comatose male with heat stroke was presented in the emergency room. The condition of the patient was complicated by hepatic failure, rhabdomyolysis, acute renal failure, and cardiac abnormalities. ECG revealed diffuse ST-T elevation; serum levels of myocardial markers were remarkably high and diffuse hypokinesis was observed on the echocardiogram. Cooling procedures, including applying cold vapor to the patient's skin, a gastric lavage with cold water, and an intravenous cold fluid infusion were not successful. Since multiple organ damage (heart, liver, central nervous system, and kidney) was evident, we utilized continuous hemodialysis and hemofiltration, using cold dialysate for efficient cooling. The patient recovered from the multiple organ damage and was removed from the intensive care unit 14 days after the onset. The cardiac abnormalities had normalized within several days without any damage to the myocardium. Q waves were not detected in any lead in the ECG. When interpreting ST-T elevation in the ECG of a heat stroke patient, caution should be used so as to not misdiagnose it as an acute myocardial infarction.

Original languageEnglish
Pages (from-to)543-550
Number of pages8
JournalInternational Heart Journal
Volume46
Issue number3
DOIs
Publication statusPublished - 2005 Jul 26

Keywords

  • Electrocardiography
  • Heat stroke
  • Multiple organ failure
  • Myocardium

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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