A comparative study of serial serum electrolytes and ECG changes in patients of heat stroke and hyperpyrexia
Authors: Shankar Vasista
Abstract:Background: Heat hyperpyrexia and heat stroke are distinct medical emergencies and common in a tropical country like India. The study compared the serial electrocardiographic (ECG) and electrolyte changes between the patients of heat stroke (HS) and heat hyperpyrexia (HP).Methods: Fourteen patients were included in each of the HS and HP groups. Patients of HS were included if they had documented rectal temperatures of (a) 106oF or more, (b) 105oF or more with neurological symptoms or anhidrosis, or along with a history of heat exposure for patients. Patients with hyperpyrexia 106oF or more due to causes other than heat stroke were included in HP group. The biochemical investigations and ECGs were recorded at before, during and after lowering of temperature of patients.Results: In HS group, serum sodium and potassium levels were lower on admission, but significantly improved (p<0.01) at 24 hours of hospitalization. Such changes were not observed in the HP group wherein, the serum sodium and potassium levels were comparable and within normal ranges on serial assessment. Hyponatremia was present in 10 (71.4%) patients on admission in HS group compared to only 1 (7.1%) patient in HP group. In both groups, all patients presented with tachycardia on ECG which returned to normal in all patients in HS group but only in 8 (57.1%) in HP group. QTc increase was noted in few patients in both groups.Conclusion: Patients of heat stroke present with hyponatremia and hypokalemia on presentation. Changes in ECG are transient in patients of heat stroke and heat hyperpyrexia.
Published on: 18-07-2018