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Exertional Heat Illness in Active Populations
Caroline E Murphy1,2, David W DeGroot3, Francis G O'Connor4
1Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
NEJM Evidence
|April 28, 2026
Summary
Exertional heat illness (EHI) is a serious risk for active people. Understanding its causes and physiological effects is key to preventing and managing this condition effectively.
Area of Science:
- Sports Medicine
- Environmental Physiology
- Exercise Science
Background:
- Exertional heat illness (EHI) is a significant cause of illness and death in athletes and military personnel.
- EHI occurs when the body cannot dissipate heat effectively due to metabolic heat, environmental conditions, and protective gear.
- Thermoregulatory functions like cardiovascular adjustments and evaporative cooling are crucial for preventing heat strain.
Purpose of the Study:
- To review the physiological mechanisms of EHI.
- To examine the impact of heat stress on the exercising heart.
- To summarize current best practices for EHI prevention, recognition, and management.
Main Methods:
- Literature review of physiological responses to heat stress during exercise.
- Analysis of factors contributing to EHI.
- Synthesis of evidence-based guidelines for clinical practice.
Main Results:
- EHI results from a failure in thermoregulation under strenuous conditions.
- Heat stress significantly impacts cardiac function during exercise.
- Effective prevention and management strategies are essential for active populations.
Conclusions:
- EHI is a preventable condition with significant health implications.
- A thorough understanding of EHI pathophysiology is vital for medical professionals.
- Implementing evidence-based practices can reduce EHI incidence and severity.
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