Stroke and heatstroke not the same ailment

DEAR DR. GOTT: I would like to know the difference between heatstroke and a massive stroke leading to death.

My friend was out most of the day in 85- to 90-degree heat. He wasn’t sick at all. He went to bed that night and fell on the floor. He couldn’t get up. About a half-hour later, he went into a coma and never came out of it.

I am blaming myself for keeping him outside. He was having a good time, even doing the chicken dance. I am wondering if the heat had anything to do with it. He was 93.

DEAR READER: The main difference between heatstroke and stroke is the heat. A typical stroke results when blood flow to the brain becomes compromised, usually because of a blood clot or bleeding into the brain. A heatstroke occurs when the body is unable to cool itself properly and internal temperatures reach 104 degrees or higher. At this temperature, tissues and organs can begin to swell and may cause brain damage or even death.

Stroke has warning signs, such as half the body becoming paralyzed, slurred speech, drooping on one side of the face and more. Sometimes no signs or symptoms are present, and in others, the symptoms are mild or occur quickly before the person loses consciousness.

Heatstroke, on the other hand, has many symptoms. It is commonly preceded by heat cramps and heat exhaustion. These are usually characterized by fatigue, excessive sweating, muscle cramps, increased thirst, headache, dizziness, nausea, lightheadedness and more. If these symptoms are ignored, the body can become dehydrated, which then results in the inability to sweat, causing the body to overheat.

If your friend was feeling ill prior to collapse, he may have suffered a heatstroke, but you say he was in good spirits and felt normal. This leads me to believe that, if he did indeed have a stroke, it was probably not the result of his outdoor activities.

A final factor is your friend’s age. At 93, our bodies are wearing down. Things don’t always work the way they should. Perhaps he did not have a stroke at all. Often, heart attack can result from strenuous activity and may not present with any symptoms. Did he have any health concerns or medical conditions that would put him at increased risk of heart attack or stroke, such as elevated cholesterol levels, family or personal history of these conditions, or hypertension? Was he on any medication? The list can go on and on, but the result is the same. Unless an autopsy was performed, there is no way to know why your friend died in the manner he did.

As for you blaming yourself, this is not necessary. You are not to blame. Even in the event that your friend suffered a heatstroke, he would have had warning signs, which he chose to ignore and not seek help for. I suggest you speak with a therapist to work out your feelings. A therapist can help you process what happened to allow you to better cope with the loss of your friend and conclude that what happened was not your fault.

To provide related information, I am sending you copies of my Health Reports “Coronary Artery Disease” and “Stroke.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order per report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).