Heat stroke in strenuous exercises: a clinical case





heat stroke, marathon, metabolic disorders, hyperthermia


According to the Association of International Marathons and Distance Races, more than 800 marathons are held annually in the world, but excessive physical activity during marathon races involves significant health risks. We would like to bring to your attention a case history of heat stroke in a young athlete during the half-marathon running, which manifested itself by heat damage to vascular endothelium of almost all organs, rapid development of disseminated intravascular coagulopathy, consumption coagulopathy, hyperfibrinolysis, multiple organ dysfunction syndrome involving the heart, lungs, liver, kidneys, gastrointestinal tract, brain, and bone marrow, which ended in death.


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Marathons in history with > 30,000 finishers. AIMS: World Running. Association of International Marathons and Distance Races. 11 July 2016. Retrieved 21 March 2017.

2015 Running USA Annual Marathon Report. RunningUSA.org. Running USA. 25 May 2016. Retrieved 21 March 2017.

Waite O., Smith A., Madge L., Spring H., Noret N. Sudden cardiac death in marathons: a systematic review. The Physician and Sportsmedicine. 2016. 44(1). 79-84. doi: 10.1080/00913847.2016.1135036.

Dayer M.J., Green I. Mortality during marathons: a narrative review of the literature. BMJ Open Sport Exerc. Med. 2019. 5(1). e000555. doi: 10.1136/bmjsem-2019-000555.

Final report of heatstroke study Japanese Association for Acute Medicine. 2014. 25. 846-862.

Wang Y., Bobb J.F., Papi B., Wang Y., Kosheleva A., Di Q., Schwartz J.D., Dominici F. Heat stroke admissions during heat waves in 1,916 US counties for the period from 1999 to 2010 and their effect modifiers. Environ Health. 2016. 15. 83.

Lim C.L. Look beyond Thermoregulation and Hydration in the Diagnosis of Heat Stroke. Med. Sci. Sports Exerc. 2016 Dec. 48(12). 2583.

Clarkson P.M. Exertional rhabdomyolysis and acute renal fai-lure in marathon runners. Sports Med. 2007. 37(4–5). 361-363. doi: 10.2165/00007256-200737040-00022.

Simons S.M., Kennedy R.G. Gastrointestinal problems in runners. Curr. Sports Med. Rep. 2004. 3(2). 112-116. doi: 10.1249/00149619-200404000-00011.

Gil S.M., Yazaki E., Evans D.F. Aetiology of running-related gastrointestinal dysfunction. How far is the finishing line? Sports Med. 1998. 26(6). 365-378. doi: 10.2165/00007256-199826060-00001.

Pals K.L., Chang R.T., Ryan A.J., Gisolfi C.V. Effect of running intensity on intestinal permeability. J. Appl. Physiol. 1985. 1997. 82(2). 571-576. doi: 10.1152/jappl.1997.82.2.571.

Oktedalen O., Lunde O.C., Opstad P.K., Aabakken L., Kvernebo K. Changes in the gastrointestinal mucosa after long-distance running. Scand. J. Gastroenterol. 1992. 27(4). 270-274. doi: 10.3109/00365529209000073.

Deitch E.A. Bacterial translocation or lymphatic drainage of toxic products from the gut: what is important in human beings? Surgery. 2002. 131(3). 241-244. doi: 10.1067/msy.2002.116408.

Toru Hifumi, Yutaka Kondo, Keiki Shimizu, Yasufumi Miyake. Heat stroke. J. Intensive Care. 2018. 6. 30.

Lim C.L., Mackinnon L.T. The roles of exercise-induced immune system disturbances in the pathology of heat stroke: the dual pathway model of heat stroke. Sports Med. 2006. 36(1). 39-64.



How to Cite

Loskutov, O., Bondar, M., Druzhyna А., Maruniak, S., & Kolesnykov, V. (2021). Heat stroke in strenuous exercises: a clinical case. EMERGENCY MEDICINE, 17(2), 116–121. https://doi.org/10.22141/2224-0586.17.2.2021.230661



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