Hypertensive crisis occurs as a new aftermath beyond post-heatstroke: A case report and literature review

Heatstroke is a life-threatening condition and the most severe form of heat-related illness, characterized by a body temperature exceeding 40°C and multiorgan failure. In the cardiovascular system, hypovolemic shock is common. There is no report of hypertensive emergencies occurring during recovery from heatstroke.

This case study presents a 55-year-old male who was initially admitted with a lung abscess, which continued to improve during hospitalization, but he subsequently developed heatstroke due to outdoor activities in high-temperature environments. During recovery from multiple organ dysfunction caused by heatstroke, the patient experienced a month-long hypertensive emergency.

After ruling out hypertension caused by infection, the persistent hypertension in the patient was highly suspected to be caused by heatstroke.

The patient was transferred to an air-conditioned room, and symptomatic supportive treatment for heatstroke was initiated. Sodium nitroprusside was administered intravenously to treat the hypertensive crisis, while Nifedipine, Metoprolol, and Irbesartan were given orally for subsequent hypertension. Finally, the patient's blood pressure gradually stabilized and remained so until the medications were discontinued.

His symptoms basically disappeared within 1 month, and the patient did not report any discomfort with 8 months of follow-up.

This case was the first report of hypertensive emergencies during recovery from heatstroke. The possible mechanisms of hypertensive emergencies during recovery from heatstroke had been explored in this case study though literature review.