Respiratory manifestations of heart stroke in the pilgrims

ABSTRACT

This study was carried out on 136 cases of heat stroke during Mecca pilgrimage of 1981. Clinical, radiological, ECG and laboratory studies including blood gases, acid base, electrolytes, enzymes, hepatic and renal functions and some hematological studies were done. Respiratory involvement was evidenced by the presence of disturbed rate or rhythm of breathing in all cases and the common finding of cyanosis [62%] X-ray chest for 82 cases revealed the presence of lobar or broncho-pneumonia in 31.4% and atelectasis of right upper lobe in two cases. Pulmonary edema was found in six cases. Hypoxemia was present in all measurements. Hypocapnia was present in the majority of cases [87.7%], while hypercapnia was found in three emphysematous and an obese patients. Serum electrolytes showed that sodium level was normal in 68.3%, low in 21.5% and high in 10.2%, while potassium level was low in 58%, none in 41.3% and high in only a case of acute renal failure [0.7%]. The multisystem involvement was evident. A relatively low mortality of 20% reflects the value of prompt diagnosis and immediate treatment