Cardiovascular and Metabolic Manifestations of Heat Stroke and Severe Heat Exhaustion
ANTHONY M. COSTRINI, M.D.* HENRY A. PITT, M.D.+ ANTHONY B. GUSTAFSON, M.D.t DAVID E. UDDIN, Ph.D.6 Parris Island, South Carolina
From the Medical Dispensary, Marine Corps Recruit Depot, Parris Island, South Carolina. The opinions or assertions contained herein are those of the authors and are not io be construed as offical or reflecting the views of the Department of the Navy or the naval service at large. Requests for reprints should be addressed to Dr. Anthony M. Costrini. Manuscript accepted August 23. 1978. * Present address: 2203 Abercorn Street, Savannah, Georgia 31401. + Present address: Department of Surgery, The
Johns Hopkins Hospital, Baltimore,Maryland 21205. t Present address: Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin 53201. g Present address: Navy Medical Research Institute, Bethesda, Maryland 20014.
296
February 1979
We
prospectively studied the clinical, biochemical (including creatine phosphokinase [CPK)isoenzymes) and electrocardiographic features of exertional heat stroke in 13 patients (group 1) and severe heat exhaustion in 14 patients (group 2). Despite initial presentations with severe hyp&thermia, tachycardia and hypotension, only one patient with heat stroke had myocardial ischemia. The CPK isoenzymes were not indicative of myocardial damage in any patient. The patients with heat stroke were somewhat more dehydrated than those with heat exhaustion as measured by differences in serum creatinine, sodium and osmolality, and the former (group 1) had a significantly lower initial glucose level (P
ANTHONY M. COSTRINI, M.D.* HENRY A. PITT, M.D.+ ANTHONY B. GUSTAFSON, M.D.t DAVID E. UDDIN, Ph.D.6 Parris Island, South Carolina
From the Medical Dispensary, Marine Corps Recruit Depot, Parris Island, South Carolina. The opinions or assertions contained herein are those of the authors and are not io be construed as offical or reflecting the views of the Department of the Navy or the naval service at large. Requests for reprints should be addressed to Dr. Anthony M. Costrini. Manuscript accepted August 23. 1978. * Present address: 2203 Abercorn Street, Savannah, Georgia 31401. + Present address: Department of Surgery, The
Johns Hopkins Hospital, Baltimore,Maryland 21205. t Present address: Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin 53201. g Present address: Navy Medical Research Institute, Bethesda, Maryland 20014.
296
February 1979
We
prospectively studied the clinical, biochemical (including creatine phosphokinase [CPK)isoenzymes) and electrocardiographic features of exertional heat stroke in 13 patients (group 1) and severe heat exhaustion in 14 patients (group 2). Despite initial presentations with severe hyp&thermia, tachycardia and hypotension, only one patient with heat stroke had myocardial ischemia. The CPK isoenzymes were not indicative of myocardial damage in any patient. The patients with heat stroke were somewhat more dehydrated than those with heat exhaustion as measured by differences in serum creatinine, sodium and osmolality, and the former (group 1) had a significantly lower initial glucose level (P
