Stress-induced cardiomyopathy accompanied by heat stroke

Abstract

Heat stroke is a severe illness characterized by a core temperature >40°C (104°F) and central nervous system abnormalities, such as delirium, convulsions, or coma, resulting from exposure to environmental heat or strenuous physical experience. We describe a case with high body temperature and coma, who also presented with wide QRS tachycardia and shock. He was initially treated for heat stroke and wide QRS tachycardia. Serial electrocardiographic change and echocardiographic findings suggested this was complicated with stress-induced cardiomyopathy. This case demonstrates the importance of recognizing that serious myocardial damage can result from heat stroke.<Learning objective: Heat stroke can cause multiple organ failure and the presentation of circulatory failure in heat stroke may be the sign of myocardial dysfunction. To distinguish acute coronary syndrome and stress-induced cardiomyopathy, both of which could be evoked by heat stroke, the evaluation of coronary artery is necessary. Stress-induced cardiomyopathy may cause lethal arrhythmia or circulatory collapse in acute phase. Invasive circulatory monitoring is recommended in patients with heat stroke.>