Heatstroke during endurance exercise: Is there evidence for excessive endothermy?

Medicine and Science in Sports and Exercise

Volumn 40, Issue 7, 2008, Pages 1193-1204

  Rae, Dale E ^a   Knobel, Gideon J ^a   Mann, Theresa ^a   Swart, Jeroen ^a   Tucker, Ross ^a   Noakes, Timothy D ^a  

^a UNIVERSITY OF CAPE TOWN   (South Africa)

Author keywords

Cardiac arrest; Endogenous heat production; Hyperthermia; Immediate cooling; Malignant hyperthermia; Sudden death

Indexed keywords

ARTICLE; ATHLETE; AUTOPSY; BODY TEMPERATURE MEASUREMENT; CONTROLLED STUDY; COOLING; CYCLING; ENDURANCE SPORT; ENVIRONMENTAL FACTOR; EXERCISE; HEART ARREST; HEAT STROKE; HOSPITALIZATION; HUMAN; MAJOR CLINICAL STUDY; RECTUM TEMPERATURE; RUNNING; VELOCITY;

ACCLIMATIZATION; ADULT; BICYCLING; BODY TEMPERATURE REGULATION; DEATH, SUDDEN, CARDIAC; EXERCISE TOLERANCE; FATAL OUTCOME; HEAT STROKE; HUMANS; KIDNEY; MALE; MUSCLE, SKELETAL; PHYSICAL ENDURANCE; RISK FACTORS; RUNNING;

EID: 46249119575     PISSN: 01959131     EISSN: 15300315     Source Type: Journal    
DOI: 10.1249/MSS.0b013e31816a7155     Document Type: Article

References (51)

1. Aarseth HP, Eide I, Skeie B, Thaulow E. Heat stroke in endurance exercise. Acta Med Scand. 1986;220(3):279-83.
2. Bartley JD. Heat stroke: is total prevention possible. Mil Med. 1977;142(7):528, 533-35.
3. Bendahan D, Kozak-Ribbcns G, Confort-Gouny S, et al. A noninvasive investigation of muscle energetics supports similarities between exertional heat stroke and malignant hyperthermia. Anesth Analg. 2001;93(3):683-9.
4. Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002; 346(25): 1978-88.
5. Bouchama A, Roberts G, Al Mohanna F, et al. Inflammatory, hemostatic, and clinical changes in a baboon experimental model for heatstroke. J Appl Physiol. 2005;98(2):697-705.
6. Broessner G, Beer R, Franz G, et al. Case report: severe heat stroke with multiple organ dysfunction - a novel intravascular treatment approach. Crit Care. 2005;9(5):R498-501.
7. Brotherhood JR. Heat stress and strain in exercise and sport. J Sci Med Sport. 2008;11(1):6-19.
8. Buskirk ER, Beetham WPJ. Dehydration and body temperature as., a result of marathon running. Med Sports. 1960;XIV(9):493-506.
9. Byrne C, Lee JK, Chew SA, Lim CL, Tan EY. Continuous ther-moregulatory responses to mass - participation distance running in heat. Med Sci Sports Exer. 2006;38(5):803-10.
10. Campb.ell IT, Ellis FR, Evans RT, Mortimer MG. Studies of body temperatures, blood lactate, cortisol and free fatty acid levels during exercise in human subjects susceptible to malignant hyper-pyrexia. Acta Anaesthesiol Scand. 1983;27(5):349-55.
11. Casa DJ, Armstrong LE, Ganio MS, Yeargin SW. Exertional heat stroke in competitive athletes. Curr Sports Med Rep. 2005;4(6): 309-17.
12. Charatan F. Ephedra supplement may have contributed to sportsman's death. BMJ. 2003;326(7387):464.
13. Cheuvront SN, Carter R III, Sawka MN. Fluid balance and endurance exercise performance. Curr Sports Med Rep. 2003;2(4):202-8.
14. Dematte JE, O'Mara K, Buescher J, et al. Near-fatal heat stroke during the 1995 heat wave in Chicago. Ann Intern Med. 1998; 129(3):173-81.
15. Dennis SC, Noakes TD. Advantages of a smaller bodymass in humans when distance-running in warm, humid conditions. Eur J Appl Physiol Occup Physiol. 1999;79(3):280-4.
16. Dickinson JG. Heat-exercise hyperpyrexia. J R Army Med Corps. 1989;135(1):27-9.
17. Hackl W, Winkler M, Mauritz W, Sporn P, Steinbereithner K. Muscle biopsy for diagnosis of malignant hyperthermia susceptibility in two patients with severe exercise-induced myolysis. Br J Anaesth. 1991;66(1): 138-40.
18. Hall AP, Henry JA. Acute toxic effects of 'Ecstasy' (MDMA) and related compounds: overview of pathophysiology and clinical management. Br J Anaesth. 2006;96(6):678-85.
19. Hanson PG, Zimmerman SW. Exertional heatstroke in novice runners. JAMA. 1979;242(2):154-7.
20. Heame KG. Hyperpyrexial heatstroke: a Mesopotamian experience, with some aetiological views and a method of prevention resulting therefrom. Med J Aust. 1932;1:226-32.
21. Hopkins PM, Ellis FR. Hyperthermic and Hypermetabolic Disorders: Exertional Heat-Stroke, Malignant Hyperthermia and Related Syndromes. London (England): Cambridge University Press; 1996. p. 1.
22. Hopkins PM, Wappler F. Is there a link between malignant hyperthermia and exertional heat illness? Br J Sports Med. 2007;41(5):283-4.
23. Hopkins PM, Ellis FR, Halsall PJ. Evidence for related myopa-thies in exertional heat stroke and malignant hyperthermia. Lancet. 1991;338(8781):1491-2.
24. Hopkins PM, Halsall PJ, Ellis FR. Investigation of exertional heat stroke 3: in vitro skeletal muscle contracture testing. In: Hopkins PM, Ellis FR, editors. Hyperthennic and Hypermetabolic Disorders: Exertional Heat-Stroke, Malignant Hyperthermia and Related Syndromes. New York: Cambridge University Press; 1996. p. 93-101.
25. Hughson RL, Sutton JR. Heat stroke in a "run for fun." Br Med J. 1978;2(6145):1158.
26. Jardon OM. Physiologic stress, heat stroke, malignant hyperthermia - a perspective. Mil Med. 1982;147(1):8-14.
27. Knochel JP. Catastrophic medical events with exhaustive exercise: "white collar rhabdomyolysis." Kidney Int. 1990;38(4):709-19.
28. Maron BJ, Poliac LC, Roberts WO. Risk for sudden cardiac death associated with marathon running. J Am Coll Cardiol. 1996;28(2): 428-31.
29. Martinez M, Devenport L, Saussy J, Martinez J. Drug-associated heat stroke. South Med J. 2002;95(8):799-802.
30. Muir AL, Percy-Robb IW, Davidson IA, Walsh EG, Passmore R. Physiological aspects of the Edinburgh Commonwealth Games. Lancet. 1970;2(7683):1125-8.
31. Muldoon S, Deuster P, Brandom B, Bunger R. Is there a link between malignant hyperthermia and exertional heat illness? Exerc Sport Sci Rev. 2004;32(4):174-9.
32. Neilan TG, Januzzi JL, Lee-Lewandrowski E, et al. Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon. Circulation. 2006; 114(22):2325-33.
33. Nicholson MR, Somerville KW. Heat stroke in a "run for fun." Br Med J. 1978; 1(6126): 1525-6.
34. Nielsen B. The regulation of core temperature by muscular work. Skand Arch Physiol. 1938;79:195-230.
35. Nielsen B. Olympics in Atlanta: a fight against physics. Med Sci Sports Exerc. 1996;28(6):665-8.
36. Noakes TD. Mind over matter: deducing heatstroke pathology. Phys Sportsmed. 2005;33(10):44-6.
37. Oh RC, Henning JS. Exertional heatstroke in an infantry soldier taking ephedra-containing dietary supplements. Mil Med. 2003; 168(6):429-30.
38. Parnell CJ, Restall J. Heat-stroke: a fatal case. Arch Emerg Med. 1986;3(2):111-4.
39. Pugh LG, Corbett JL, Johnson RH. Rectal temperatures, weight losses, and sweat rates in marathon running. J Appl Physiol. 1967; 23(3):347-52.
40. Roberts WO. Exertional heat stroke during a cool weather marathon: a case study. Med Sci Sports Exerc. 2006;38(7):1197-203.
41. Rubel LR. Case for diagnosis: exertional heatstroke. Mil Med. 1983;148(9):756, 758.
42. Shapiro Y, Seidman DS. Field and clinical observations of exertional heat stroke patients. Med Sci Sports Exerc. 1990;22(1):6-14.
43. Sutton J, Coleman MJ, Millar AP, Lazarus L, Russo P. The medical problems of mass participation in athletic competition. The "City-to-Surf" race. Med J Aust. 1972;2(3):127-33.
44. Tamopolsky MA. Metabolic myopathies of physical activity. Phys Sportsmed. 2002;30(6):37-46.
45. Tobin JR, Jason DR, Challa VR, Nelson TE, Sambuughin N. Malignant hyperthermia and apparent heat stroke. JAMA. 2001; 286(2):168-9.
46. Tucker R, Marie T, Lambert EV, Noakes TD. The rate of heat storage mediates an anticipatory reduction in exercise intensity during cycling at a fixed rating of perceived exertion. J Physiol. 2006;574(Pt 3):905-15.
47. Tunstall Pedoe DS. Marathon cardiac deaths: the London experience. Sports Med. 2007;37(4-5):448-50.
48. Vanuxem P, Vanuxem D, Raharison L, Aubert M, Pouliquen G, Deslangles O. Maximal exercise and muscle energy metabolism after recovery from exercise hyperthermia syndrome. Muscle Nerve. 2001;24(8):1071-7.
49. Wappler F, Fiege M, Steinfath M, et al. Evidence for susceptibility to malignant hyperthermia in patients with exercise-induced rhabdomyolysis. Anesthesiology. 2001;94(1): 95-100.
50. Weaving EA, Berro VE, Kew MC. Heat stroke during a 'run for fun': a case report. S Afr Med J. 1980;57(18):753-4.
51. Wyndham CH, Strydom NB. The danger of an inadequate water intake during marathon running. S Afr Med J. 1969;43(29): 893-6.