Decoding the heat stroke and cardiac arrest connect

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    अगर आप हैं दिल के रोगों से परेशान तो मत होइए दुखी, वैज्ञानिकों ने खोजा ये तरीका

    DR. DIPAK BUKHTAR, GENERAL PHYSICIAN AT SRV MAMATA HOSPITAL
    constant headaches, or suffering from high body temperature or rapid

    Do you feel uneasy owing to the scorching heat? Are you experiencing
    breathing? Then, it could be heat stroke. Nowadays, It is not uncommon
    to for summer temperatures to climb 40 মbsp;C, dry heat is experienced in
    many parts of the country and is causing several health hazards
    including heat stroke.

    ALL YOU NEED TO KNOW ABOUT IT:

    Heat stroke was first described by the Romans, as early as in the year
    24 BC. Since then, Heat stroke has been a potentially fatal condition
    that results from elevated core body temperature of 104 মbsp;F (40 মbsp;C) or
    higher leading to acute dysfunction of the central nervous system,
    cardiac renal and muscular system. It is a medical emergency leading to
    mortality of 50 per cent, if not treated promptly.

    THE TYPES OF IT:

    EXERTIONAL HEAT STROKE: Exertional heat stroke (EHS) can be defined as
    life-threatening hyperthermia (core body temperature ≥ 40.5 übr>[105 Ɲ) and dysfunction of central nervous system (CNS). You will be
    shocked to know that EHS is one of the top three causes of sudden death
    in athletes.

    NON-EXERTIONAL HEAT STROKE (NEHS): It tends to commonly affect sedentary
    elderly, persons who are chronically ill and very young people.

    THE CAUSES:

    Heat stroke may be caused secondary to prolonged exposure to a high
    environmental temperature or physical exertion in high temperatures. It
    can occur due to dysfunction of the muscular and central nervous
    systems, myocardial infarction, and renal failure. The condition is a
    medical emergency with an estimated mortality rate of 10-50 per cent.

    Delay in treatment increases the risk of multi-organ dysfunction and
    even death. Be it exertional or non-exertional heat stroke, severity can
    be exacerbated due to wearing excess clothing, drinking alcohol, and not
    consuming adequate amounts of other fluids.

    DECODING THE RELATIONSHIP BETWEEN HEAT STROKE AND CARDIAC ARREST

    Cardiac arrest refers to a disorder wherein pumping of blood to the
    heart and other organs is stopped, commonly occurs as a result of
    electrical signal dysfunction in the heart (arrhythmia). The brain is
    starved of oxygen in such cases, which may lead to loss of
    consciousness, and stoppage of breathing. Heat stroke has been reported
    to cause cardiovascular related abnormalities such as low blood
    pressure, malignant arrhythmias, myocardial ischemia, conduction related
    changes, etc. Initial symptoms of heat stroke may mimic that of heart
    abnormalities and there is evidence of global depression of cardiac
    function in such cases.

    Extreme exertion, as in individuals training for sporting/military
    events, in outdoor settings in extremely hot temperatures is the chief
    cause for exertional heatstroke. Also, the affected individuals may
    present with symptoms of cardiac arrest such as confusion, difficulty in
    breathing, sudden collapse/loss of consciousness, and lack of response
    within seconds. Such cases of heatstroke tend to develop additional
    multi-organ damage as blood flow to the heart is affected. With
    appropriate care in the intensive care unit, steady recovery may be
    achieved.

    Sudden exposure to hot weather may also predispose an individual to heat
    stroke and subsequent cardiac arrest. This is because the body does not
    have the time to acclimatize to the drastic change and causes
    dehydration. Subsequent derangement of electrolytes may lead to changes
    in electrical signaling of the heart and can lead to cardiac arrest.

    Individuals under certain medications such as vasoconstrictors (used for
    narrowing blood vessels), beta-blockers (for high blood pressure),
    diuretics (for sodium and water balance), anti-depressants, etc. may be
    more susceptible to heat stroke. Being obese and leading a sedentary
    lifestyle are the common risk factors associated with both heatstroke
    and cardiac arrest.

    THE SYMPTOMS

    The common symptoms of heat stroke include, High core body temperature
    (104 মbsp;F/40 মbsp;C or higher), hot red dry or damp skin, rapid pulse,
    headache, dizziness, nausea, confusion, and loss of consciousness. The
    rectal thermometer is used to obtain the core body temperature. In heat
    stroke due to hot weather, the skin will  burn and may also dry out.
    However, in heatstroke due to strenuous exercise, the skin may feel dry
    or slightly moist. Hence, you should seek immediate medical attention.
    Furthermore, one may also exhibit symptoms like a high core body tempt,
    temperature 104 degree, rectal temperature is measured to obtain core
    body temperature, dry skin,  confusion, disorientation, delirium,
    convulsions can occur in extreme cases and palpitation.

    COMPLICATIONS OF HEAT STROKE:

    •   Central Nervous System (CNS): Acute confusion state (Delirium) and
    convulsions

    •    Cardiac: Arrhythmias, hypotension, cardiac arrest

    •    Kidney: Acute kidney injury related to muscle toxins

    •    Muscular system: Rhabdomyolysis- muscular breakdown, stiffness,
    rigidity

    WHO IS AT THE RISK OF IT?

    •    Toddlers, sportspersons, military units, elderly, diabetics,
    indulging in extreme physical activity in high temperature, can lead to
    the development of heat stroke.

    •    Patients taking certain medications including diuretics,
    B-blockers, anti-depressive medicines, anti hypertensive medications
    have blunted response to high temperature, causing a heat stroke.

    THE TREATMENT:

    •    Medical care is essential to treat both heatstroke and resultant
    cardiac arrest. Initial management involves moving the person to a
    cooler place.  The body temperature of the person should be reduced with
    the help of ice packs and cool towels.

    •  Do not give the one suffering from heat stroke anything to drink.
    Contact emergency services immediately as in-hospital aggressive
    reduction of body temperature during the golden hour (usually within an
    hour of the stroke) is vital to avoid cardiac and organ failure.

    •  The goal of the treatment is to reduce the core body temperature by
    at least 0.2 ï min to approximately 39 মbsp;C. Care must be taken to
    prevent extreme cooling and subsequent hypothermia.

    • One the other hand, cardiac arrest is usually treated by
    cardiopulmonary resuscitation (CPR) and by use of a defibrillator. The
    purpose of CPR is to pump the heart to revive blood flow and circulation
    to organs. The defibrillator is a device that delivers an electric shock
    to the heart in an attempt to restore its normal rhythm.

    • Calcium may be administered in patients with a known history of
    arrhythmias and high potassium levels.

    •    Glucose and salts are indicated to treat electrolyte imbalance
    and muscle breakdown.

    •    Other medications may be advised for the management of symptoms.

    •    Ventilator support may be needed in patients who are finding it
    difficult to breathe.

    FOLLOW THESE PREVENTIVE TIPS:

    •    As mentioned earlier, adequate hydration is the key to most
    health problems arising in the summer season. Two-thirds of our body is
    comprised of water, which plays a major role in regulating body
    temperature. It is imperative to consume adequate fluids, especially
    when outdoors to prevent dehydration.

    •    Wear loose-fitting, cotton clothes that allow the body to cool
    properly.

    •    Do not underestimate the need for sunscreen as protection against
    sunburn is equally important.

    •     Opt for caps, hats, umbrella, scarves, socks, and sunglasses to
    protect yourself from the harsh sun rays, especially during afternoon.

    •    You need to be aware of any medication that you may be taking for
    systemic health conditions. So, discuss with your physician if any
    medication can increase your risk of heatstroke.

    •    Remember not to sit inside a car (especially do not lock children
    inside the car) parked in the sun. Internal temperatures may rise by
    5-7 মbsp;C in a locked car within 10 minutes, which may lead to heatstroke
    and suffocation.

    •    Avoid strenuous activity and plan your work such that you avoid
    exposure to the sun during the hottest hours of the day. Let your body
    adjust to the hot climate, as it may take up to several days to do so.

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