Skip to main content

Muscular Metabolism and Contraction in Exertional Heat Stroke

  • Chapter
Exercise Intolerance and Muscle Contracture

Abstract

A number of similarities have been observed between malignant hyperthermia (MH) and exertional heat stroke (EHS) syndromes. Malignant hyperthermia is a pharmacogenetic syndrome appearing in predisposed subjects characterized by rigidity and accelerated metabolism of skeletal muscles leading to a dramatic increase in core temperature. MH occurs in susceptible subjects after exposure to triggering agents such as inhalational fluorinated anesthetics and depolarizing muscle relaxants [1–3]. Exertional heat stroke (EHS), also called exercise hyperthermia, is characterized by hyperthermia above 40°C, neurological signs and rhabdomyolysis [1,4]. This syndrome occurs during intense, extended physical effort not only in hot and humid climatic conditions. Patients are healthy young adults who have no apparent clinical or biological deficit. Since the hypothesis of a preexisting muscular disorder was raised in EHS patients, our objective was to investigate the etiology of EHS and the possible link between EHS and malignant anaesthetic hyperthermia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kozak Reiss G, Coursanges M, Aubert M (1991) Hyperthermies malignes. Editions Techniques. Encycl Med Chir (Paris-France), Techniques Chirurgicales — Anesthésie Réanimation, 364 12 E 10, 18p

    Google Scholar 

  2. Mac Lennan DH, Phillips MS (1992) Malignant hyperthermia. Science 256:789–794

    Article  Google Scholar 

  3. Serratrice G, Kozak-Ribbens G (1996) Hyperthermie Maligne. Encycl Med Chirg, Neurologie, I. Médicaux 171:A-50

    Google Scholar 

  4. Aubert M, Petrognani R, Deslangles O (1993) Exertional Heat Stroke. In: Aubert M, Borsarelli J, Khambatta HJ, Kozak-Ribbens G (eds) Malignant Hyperthemias. Normed verlag Bad Homburg Englewood Madrid, pp 52–71

    Google Scholar 

  5. Kozak Reiss G, Borsarelli J (1990) “A rapid and extensive investigation of MH patients in Marseille by a pluridisciplinary integrated structure”. 7th International Workshop on Malignant Hyperthermia, Munich 22–23 september. J Neurol Sci 98S:518

    Google Scholar 

  6. Kozak-Ribbens G (1993) Investigation and diagnosis of malignant and exercise hyperthermias. In: Aubert M, Borsarelli J, Khambatta HJ, Kozak Ribbens G (eds) Malignant Hyperthemias. Normed verlag Bad Homburg Englewood Madrid, pp 44–62

    Google Scholar 

  7. The European Malignant Hyperpyrexia Group, Ellis FR et al (1984) A protocol for the investigation of Malignant Hyperpyrexia (MH) susceptibility. Br J Anaesth 56:1267–1273

    Article  Google Scholar 

  8. Bendahan D, Confort-Gouny S, Kozak-Ribbens G, Cozzone PJ (1993) Investigation of metabolic myopathies by P-31 MRS using a standardized rest-exercise-recovery protocol: a survey of 800 explorations. MAGMA 1:91–104

    Article  CAS  Google Scholar 

  9. Mickelson JR, Louis CF (1996) Malignant hyperthermia: excitation-contraction coupling, Cat+release channel and cell Cat regulation defects. Physiol Rev 537–592

    Google Scholar 

  10. Figarella-Branger D, Kozak-Ribbens G, Rodet L, Aubert M, Borsarelli J, Cozzone PJ, Pellissier JF (1993) Pathological findings in 165 patients explored for Malignant Hyperthermia susceptibility. Neuromusc Disord 3(5/6):553–556

    Article  PubMed  CAS  Google Scholar 

  11. Legros P, Jehenson P, Gascard JP, Kozak Reiss G (1992) Long term relationship between acute rhabdomyolysis and abnormal end energy phosphate metabolism potentiated by ischemic exercise. Medecine and Science in sports and Exercise 24:298–302

    CAS  Google Scholar 

  12. Bendahan D, Kozak-Ribbens G, Rodet L, Confort-Gouny S, Cozzone PJ (1998) 31 Phosphorus Magnetic Resonance Spectroscopy Characterization of muscular metabolic anomalies in patients with malignant hyperthermia. Anesthesiology 88:96–107

    Article  PubMed  CAS  Google Scholar 

  13. Hopkins PM, Ellis FR, Halsall PJ (1991) Evidence for related myopathies in exertional heat stroke and malignant hyperthermia. Lancet 338:1491–1492

    Article  PubMed  CAS  Google Scholar 

  14. Hackl W, Winckler M, Mauritz W, Sporn P, Steinbereithner K (1991) Muscle biopsy for diagnosis of malignant hyperthermia susceptibility in two patients with severe exercise-induced myolysis. Br J Anaesth 66:138–140

    Article  PubMed  CAS  Google Scholar 

  15. Kozak Reiss G, Gascard JP, Hervé P, Jehenson P, Syrota A (1988) Malignant and exercise hyperthermia: investigation of 73 subjects by contracture tests and P 31 NMR spectroscopy. Anesthesiology 69 (3A):415

    Article  Google Scholar 

  16. Monnier N, Canet C, Krivosic Horber R, Adnet P, Reyford H, Kozak-Ribbens G, Rodet L, Cozzone PJ, Stieglitz P, NivocheY, Desmonts JM, Lunardi J (1994) Genetic linkage analysis of French Malignant Hyperthermia population. Minerva Anestesiol 60(S 3):25–30

    Google Scholar 

  17. Sudbrak R, Procaccio V, Klausnitzer M, Curran JL, Monsieurs K, Van Broeckhoven C, Ellis FR, Heytens L, Hartung EJ, Kozak Ribbens G, Heilinger D, Weissenbach J, Lehmann Horn, Mueller CR, Deufel T, Stewart AD, Lunardi J (1995) Mapping of a further malignant hyperthermia susceptibility (MHS) locus to chromosome 3Q13.1. Am J Hum Genet 56:684–691

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

All physicians from the military and university hospitals are acknowledged for patients referrals

This work was supported by grants from DRSSA (Direction de la Recherche du Service de Santé des Armées), APHM (Assistance Publique des Hopitaux de Marseille), CNRS (Centre National de la Recherche Scientifique), AFM (Association Française contre les Myopathies) and PHRC (Programme Hospitalier de Recherche Clinique).

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag France

About this chapter

Cite this chapter

Kozak-Ribbens, G., Aubert, M., Figarella-Branger, D., Bendahan, D., Cozzone, P.J. (1999). Muscular Metabolism and Contraction in Exertional Heat Stroke. In: Serratrice, G., Pouget, J., Azulay, JP. (eds) Exercise Intolerance and Muscle Contracture. Springer, Paris. https://doi.org/10.1007/978-2-8178-0855-0_10

Download citation

  • DOI: https://doi.org/10.1007/978-2-8178-0855-0_10

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-59669-8

  • Online ISBN: 978-2-8178-0855-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics