Noakes reported a classification for exercise-related heat illness. Not all reasons for collapse during exercise in heat are associated with an elevated core body temperature. The author is from the University of Cape Town in South Africa.

Classification begins by determining whether or not there is an increase in body heat storage.


Heatstroke (pathological increase in body heat storage causing an elevated core temperature, usually > 41.5°C):

(1) exercise and environmentally induced heat stroke (EEHS)

(1a) inadequate heat loss during exercise

(1b) excessive endogenous heat production during exercise

(1c) combination of both

(2) other causes of heat stroke not related to exercise


Conditions with no pathological increase in body heat storage:

(1) exercise-associated postural hypotension

(2) other (dehydration, etc)


Identifying the various contributory processes is important for management. In heatstroke there is a need to rapidly reduce body temperature and to avoid rhabdomyloysis. These are not necessary in conditions where there is no increase in body heat storage.

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