Exertional heat stroke:: I -: Clinical aspects and prevention

Purpose. -To provide the medical community and anybody involved in sport management with a common medical view of what is exertional heat stroke and the way to prevent it. Actualities. -Among the physical activity-related accidents which feature a high level of core temperature, we should now distinguish: . exertional heatstroke, experienced by young fit subjects during a strenuous exercise 30 to 60 min. long; . heat exhaustion which is a most common accident observed in dehydrated people after a very long exercise; . and common heat stroke which is observed in active subjects submitted to harsh ambient conditions. The important clinical variability of exertional heatstroke is partly linked to the diversity of its pathogenic mechanisms; they are discussed in the second part of this file. They allow a comprehensive description of the numerous factors able to precipitate the time course of heatstroke in external (mainly climatic), internal and circumstantial factors. Perspectives. -This guide allowing the actors involved in the treatment and the prevention of exertional heatstroke to better communicate should also help them to better anticipate the precipitating factors of heatstroke and therefore to better prevent this accident. Conclusion. -It is now possible to isolate exertional heat stroke from other types of accident observed during exercise which features a high core temperature. A comprehensive medical and operational description of exertional heatstroke is presented in this article. (C) 2003 Editions scientifiques et medicales Elsevier SAS. Tous droits reserves.