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Heat Exhaustion

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Exertional Heat Illness

Abstract

Exertional heat exhaustion (H EX) is the most prevalent form of heat illness in athletic, industrial, and military settings. The common etiological features include dehydration, high ambient temperature/humidity/solar radiation with slow air movement, and strenuous/prolonged exercise. The fundamental pathophysiology of H EX involves total body water and whole-body sodium deficits, mild hyperthermia, and great cardiovascular strain. Although some authorities believe that H EX represents only postural hypotension leading to collapse, numerous clinical and physiological publications have described H EX in a variety of scenarios and concluded that H EX involves more than postural hypotension per se. Recognition of H EX focuses on great fatigue or muscular weakness, mild rectal temperature elevation, nausea, vomiting, and the signs and symptoms that reflect dehydration (i.e., whole-body sodium and body water deficits) plus circulatory insufficiency (e.g., hypotension, ashen skin). When H EX patients collapse and/or exhibit altered mental status, severe H EX is indicated; they have reached the limits of cardiovascular compensation, and hyperthermia adds additional stress to existing cardiovascular insufficiency. Mild H EX with no other symptoms may be treated with rest and leg elevation, but severe H EX cases that involve large fluid losses and tachycardia at rest should be treated by judicious administration of intravenous fluid, under supervision of a physician. Exercise-heat acclimatization across 8–10 days improves orthostatic intolerance, enhances cardiovascular stability, reduces salt losses in sweat and urine, and expands plasma (extracellular) volume; the resulting adaptations improve heat tolerance and enhance ability to work and exercise in the heat.

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Author information

Authors and Affiliations

  1. Hydration & Nutrition, LLC, Newport News, VA, USA

    Lawrence E. Armstrong

  2. Department of Kinesiology (Professor Emeritus), University of Connecticut, Storrs, CT, USA

    Lawrence E. Armstrong

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  1. Lawrence E. Armstrong
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Correspondence to Lawrence E. Armstrong .

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Editors and Affiliations

  1. Department of Kinesiology University of North Carolina at Greensboro, Greensboro, NC, USA

    William M. Adams

  2. Korey Stringer Institute, University of Connecticut, Storrs, CT, USA

    John F. Jardine

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Armstrong, L.E. (2020). Heat Exhaustion. In: Adams, W., Jardine, J. (eds) Exertional Heat Illness. Springer, Cham. https://doi.org/10.1007/978-3-030-27805-2_5

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  • DOI: https://doi.org/10.1007/978-3-030-27805-2_5

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-030-27805-2

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