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Is It Exertional Heatstroke or Something More? A Case Report
Casper Reske-Nielsen1, Katherine Schlosser2, Robert C Pascucci2
1Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts.
The Journal of Emergency Medicine
|April 5, 2016
Summary
Exertional heat stroke can mimic malignant hyperthermia (MH). Prompt recognition and dantrolene sodium administration are crucial for patients with suspected MH, even if presenting with heat illness symptoms.
Area of Science:
- Emergency Medicine
- Medical Genetics
Background:
- Hyperthermia is a key symptom of heat stroke, heat-related illness, and malignant hyperthermia (MH).
- Malignant hyperthermia is a rare, life-threatening condition requiring immediate recognition and specific treatment.
- Emerging research links gene mutations to susceptibility for non-anesthetic or exercise-induced MH.
Observation:
- A 19-year-old male with a family history of MH presented with exertional heat stroke.
- Despite cooling and fluid resuscitation, the patient experienced worsening rhabdomyolysis.
- Rhabdomyolysis resolved after administration of dantrolene sodium.
Findings:
- This case highlights the potential overlap between exertional heat stroke and malignant hyperthermia.
- Dantrolene sodium proved effective in managing severe rhabdomyolysis in this context.
- Early recognition of MH in heat stroke patients is critical.
Implications:
- Emergency physicians must consider malignant hyperthermia in patients with severe heat-related illness, especially those with risk factors.
- Understanding the link between exertional heat stroke and MH can guide treatment decisions.
- Prompt dantrolene administration may be life-saving in suspected MH cases presenting as heat illness.
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