Fatal Heat Stroke in a Schizophrenic Patient

Table 3

Heat illness.

	Edema	Cramps	Tetany	Syncope	Exhaustion	Stroke
Symptoms	Minimal clinical significance but important interstitial fluid accumulation	Cramps	Cramps, carpopedal spasm, and perioral and distal paresthesias	Nausea, sighing, yawning, restlessness, and orthostatic syncope	Flulike	Flulike
Central nervous; system; symptoms	NO	NO	NO	NO	NO	Present
Temperature	<41°C	<41°C	<41°C	<41°C	<41°C	>41°C
Sweating	Present	Present	Present	Present	Present	Absent
Mechanism	Unacclimatisation, peripheral vasodilatation	Unacclimatisation and negative sodium balance	Unacclimatisation and severe negative sodium balance	Unacclimatisation, dehydration and inadequate cardiac output	Excess sweating in a hot humid environment causing volume depletion	Heat production exceeds dissipation
Treatment	Periodic exercise, elevation of the legs, or diuretic medication	Oral sodium replacement	Oral or parenteral sodium replacement	Placing supine position, and replacing water deficit	Cool area to rest, placing supine position and replacing water deficit	Emergency treatment