Heat stroke during the 2025 summer heatwave in Northwestern India: A tertiary care emergency department case series

Abstract: Heat stroke is a life-threatening medical emergency, characterized by a core body temperature above 40°C with central nervous system dysfunction. Population living in arid and northwestern regions are particularly vulnerable during prolonged summer heatwaves. This case series describes the clinical spectrum and outcomes of patients with heat stroke presenting to the emergency department of a tertiary care teaching hospital in such a region during the 2025 heatwaves. We retrospectively reviewed 10 consecutive patients with heat stroke admitted between May 1, 2025 and July 31, 2025. Data on demographics, clinical presentation, cooling methods, laboratory parameters, complications, and outcomes were extracted from the medical records. Ten patients (7 male and 3 female) ranged in age from 22 to 78 years; six had classic (nonexertional) heat stroke; and four had exertional heat stroke (EHS). All presented with hyperthermia (mean 41.2°C) and altered mental status, ranging from agitation to coma. The complications were frequent: acute kidney injury occurred in 70% of patients, severe rhabdomyolysis (creatine phosphokinase >10,000 U/L) in 40% (all EHS), hepatic dysfunction in 80%, and disseminated intravascular coagulation in 20%. Rapid, active cooling was initiated in all cases. The overall in-hospital mortality was 20%. This series highlights the severe, multisystem nature of heat stroke in this setting and underlines the importance of early recognition, prompt cooling, and aggressive supportive care.