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Hyperthermia

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Hyperthermia is a medical condition where a person's body temperature rises above normal levels. This happens because the body's thermoregulation fails. Thermoregulation is the process the body uses to maintain a stable internal temperature. In hyperthermia, the body produces or absorbs more heat than it can release. This is different from a fever. In a fever, the brain's hypothalamus changes the body's temperature set point. In hyperthermia, the set point remains unchanged, but the temperature climbs anyway.

fever-conceptual
fever-conceptual

This condition is very serious. Nearly half a million deaths are recorded every year because of hyperthermia.

The body has specific ways to lose heat. One way is through sweating, which uses evaporation to cool the skin. Another way is vasodilation. This is when blood vessels near the skin widen to release heat. This process relies on the temperature difference between the body and its surroundings. If the environment is very hot or humid, these systems may fail. High humidity makes it harder for sweat to evaporate. Without evaporation, the body cannot cool itself effectively. This can lead to a dangerous rise in core temperature.

There are different types of heat stroke. Exertional heat stroke happens during intense physical activity. This occurs when moving a lot in hot conditions generates more internal heat than the body can shed. Situational heat stroke happens without physical exertion. This type mostly affects the very young and the elderly. For older people, certain medications can make this worse. Some drugs reduce the body's ability to sweat or use vasodilation. This makes it harder for the body to tolerate high environmental temperatures.

Hyperthermia can also be caused by drugs or medical issues. Some psychotropic medications, such as SSRIs or MAOIs, can cause it. There is also a rare reaction called serotonin syndrome. Another rare condition is neuroleptic malignant syndrome, which involves muscle rigidity. Some people have a genetic predisposition to malignant hyperthermia. This is a rare reaction to certain anesthetic agents used during surgery. Other causes include traumatic brain injuries or damage to the hypothalamus. The hypothalamus is the part of the brain that controls temperature.

As the body temperature rises, it affects chemistry at a cellular level. The body relies on enzymes to run essential metabolic pathways. Enzymes are proteins that help speed up chemical reactions. High heat can cause these enzymes to denature. When enzymes denature, they lose their shape and can no longer work. This affects organs with high energy demands, such as the heart and the brain. This breakdown can lead to organ failure or even death.

fever-conceptual
fever-conceptual

Symptoms of hyperthermia change as the condition progresses. Early stages, often called heat exhaustion, include heavy sweating and a rapid pulse. As it moves toward heat stroke, the skin may become hot and dry. This happens because the body can no longer produce sweat. Other signs include nausea, vomiting, and headaches. In severe cases, a person might experience confusion, aggression, or seizures. The heart rate and breathing rate will increase to try to maintain circulation. Eventually, the person may lose consciousness.

History shows us how extreme these temperatures can be. On July 10, 1980, a man survived a serious case of heat stroke. His body temperature was measured at more than 115.7 degrees Fahrenheit. This is a remarkably high temperature for a living person. We also see the impact of heat in specific events. During the July 1995 heatwave in Chicago, at least 700 people died from heat-related issues.

heat-related deaths
heat-related deaths

People living alone or without air conditioning faced the highest risks during this time.

Hyperthermia is also a risk for people wearing protective gear. Personal protective equipment (PPE) is used by doctors and military workers. Some suits, like hazmat suits, can trap heat around the body. This creates a microclimate that makes sweating ineffective. During the 2014 Ebola epidemic, doctors could only work for 40 minutes at a time. They had to stop because they feared heat stroke. This shows how even tools meant to protect us can create new environmental dangers.

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