Clinical Spectrum of Heatstroke in a Tertiary Care Hospital during the 2024 Delhi Heat wave Peak

Abstract Background: Heat-related illnesses (HRIs) have a wide spectrum from relatively mild heat cramps to heatstroke in its severest form. The 2024 heat wave in Delhi, with temperatures consistently above 40°C, resulted in over 270 deaths due to heatstroke. This study examines nine cases of classical heatstroke admitted over a 24-h period to a tertiary care hospital in Delhi. Materials and Methods: This is a cross-sectional study of patients presenting to emergency with altered consciousness during the 24-h period just before the culmination of the 40-day long heat wave period. In the absence of alternative etiologies on the investigation, a diagnosis of classical heatstroke was entertained. The sociodemographic details, clinical features, investigations, treatment, and outcomes of nine such patients are being reported. Results: Common symptoms observed in the patients were hyperthermia (100%), dehydration (100%), altered sensorium (100%), vomiting (33%), and seizures (33%). Laboratory findings showed respiratory alkalosis (100%), hypokalemia (88.8%), thrombocytopenia (88.8%), and transaminitis (77.7%). Eight heatstroke patients required mechanical ventilation. Despite intensive treatment, three patients died, whereas six were discharged in stable condition. Conclusion: The 2024 heat wave in Delhi highlighted the severe impact of extreme heat on health. The spectrum of clinical features in classical heatstroke has been outlined. The impact of heat wave was such that even normal individuals accustomed to high-heat environments developed HRI. Early recognition and rapid cooling are crucial in managing heatstroke. Improved public awareness, healthcare infrastructure, and management protocols are essential to mitigate the effects of future heat waves.