Exertional heat stroke in athletes

Exercising in hot and especially humid environment can cause rise in body core temperature to such a critical level that it does not only reduce performance, but also may ultimately lead to exertional heat stroke (EHS). This illness is true medical emergency that can result in significant morbidity and mortality, if not early recognized and promptly treated. Diagnostic criteria for EHS are body core temperature above 40°C and central nerve system dysfunction. Any athlete experiencing such symptoms should be immediately exposed to aggressive cooling treatment aimed to lower the elevated core temperature to near normal as quickly as possible. Ice water immersion is highly recommended as a cooling method because it provides the fastest cooling rates and is associated with lowest mortality rates. Athletes cooled rapidly soon after the onset of EHS usually recover without complications and are able to return to normal training in hot environment within a few weeks. EHS is also a preventable condition, and its occurrence can be minimized by implementing a few simple measures.