50-plus? Take guard against killer heat

KOLKATA: Fifty-three-year-old Hemchandra De collapsed on the road on his way back from office last week. A blood sugar patient, De suffered a heat stroke, precipitated by prolonged exposure to the heat. But even before he could be rushed to hospital, he had a heart attack and subsequently suffered a liver disorder and a lung dysfunction. Doctors described his condition as multi-organ failure precipitated by heat stroke a disorder that has afflicted scores of fifty-plus patients in Kolkata this summer.
The dry and hot spell that has gripped the city is ideal for triggering heat strokes, according to doctors. Animals, too, have been falling prey. Two horses succumbed to heat stroke at the Maidan on Friday morning.
Of the two kinds of heat strokes classical and exertional the latter is considered to be more lethal. The one striking Kolkatans falls somewhere in between the two, said experts. "It is closer to the exertional variety which is caused by prolonged exposure to high environmental temperature. Usually, when the core body temperature crosses 40.6 degrees, hypothalamus the temperature regulating zone of the brain malfunctions. It could precipitate blood coagulation and lead to a diffused myocardial injury or heart failure. In extreme cases, multi-organ failures are also happening. Those in their fifties are especially vulnerable," said Debashish Basu, in-charge, Apollo Sugar and Heart Clinic.
Alokesh Ray, a 48-year-old executive, felt a shooting pain in his chest after walking in the sun for about half an hour. He walked straight into a hospital and got himself admitted after doctors said he had suffered a mild heart attack. "I was surprised, for even though I felt a dizziness due to the heat, a heart attack was the last thing I had expected," said Ray.
Loss of electrolytes through sweating and body radiation has been triggering localized thrombosis, explained doctors. "Dizziness and subsequent fainting are the most common symptoms of heat stroke. But delayed complications could be more dangerous and that's what has been happening. It's difficult to predict if a heat stroke will lead to a multi-organ failure or a heart attack. Heat retention is an indicator. If the patient doesn't sweat, the hypothalamus failure could be more acute and the chances of organ failure higher," said Arijit Bose, trauma care specialist.
A hot, dry skin, laboured breathing and sweating are the common symptoms of heat stroke. Doctors recommend ice bath and a vigorous massage in case the patient complains of chest pain or loses orientation. Putting the patient on a drip could be dangerous for a sudden rush of fluids into the parched system might choke the lungs. This also raises the chances of a heart failure.
Scores of children below eight years have suffered heat stroke this summer. Loss of fluids is the principal reason while the stroke is often being followed by a viral diarrhoea attack. "The frequency has been alarming this year. Those running a temperature shouldn't be leaving home. Children should be made to carry a bottle of ORS to replenish fluid loss," said paediatrician Shantanu Ray.
Slow intake of fluids with ice treatment is recommended. "Those in their fifties should be given a chest massage in case they have a breathing problem," said Bose. With the humidity steadily climbing, experts felt the number of victims could rise as well.
Even though they acclimatise better to heat than humans, animals could suffer heat strokes as well. Those without a fur coat are more vulnerable. "It is unusual but animals like horses that don't have a fur protection were more likely to suffer a heat stroke than the rest. Like humans, they, too, suffer a hypothalamus failure and their kidneys stop functioning," explained a veterinarian.