The Educated Patient Podcast: Heat Cramps, Heat Exhaustion and Heat Stroke

As temperatures rise and outdoor activity picks up, heat-related illness becomes one of the most common (and most preventable) medical emergencies of the summer season. On a recent episode of The Educated Patient Podcast, host Mike DeMarco sat down with Juan Dangond, D.O., an urgent care physician at Baptist Health South Florida, to break down everything listeners need to know about recognizing, responding to and recovering from heat illness.

Three Stages, One Spectrum

Dangond organizes heat-related illness into three categories of increasing severity: heat cramps, heat exhaustion and heat stroke. Heat cramps are the mildest, essentially the same muscle cramping most people have experienced, but occurring in a hot environment when the body is not properly acclimated or hydrated. Heat exhaustion steps up the severity, with core temperature rising but staying below 104 degrees Fahrenheit. Symptoms include weakness, dizziness, headache, nausea, increased heart rate and fatigue, but critically, the person can still communicate coherently. Heat stroke is a medical emergency: Core temperature exceeds 104 degrees, and the person becomes confused, altered or incoherent. Call 911 immediately.

One of Dangond’s most important points is that these stages do not always progress sequentially. “Somebody can quite literally just drop and be in heat stroke immediately,” he says, particularly in young children, the elderly and those with significant medical conditions.

Acclimatization Is Everything

Whether you are a casual fan at an outdoor stadium or a world-class athlete, your body needs time to adjust to new heat conditions — up to seven days for significant temperature changes. Simply being indoors in air conditioning does not count. The body needs actual exposure to sun and heat to learn how much sweat to produce and how to manage hydration. Dangond references World Cup players who have been photographed sunbathing not for leisure but on the direct recommendation of team physicians preparing them for competition in unfamiliar heat.

What to Do When Someone Is in Trouble

For heat exhaustion, get the person out of the sun immediately, remove as much clothing as possible, move them to air conditioning, apply cool water or ice packs to the armpits, groin and neck, and call 911. For heat stroke, do all of the above and do not wait. Altered mental status in hot conditions should be treated as a medical emergency without hesitation.

Who Is Most at Risk

Beyond age extremes, Dangond highlights several conditions that lower the threshold for heat illness: heart disease, diabetes, kidney disease and certain medications, including blood pressure drugs, diuretics and psychiatric medications. Outdoor workers are also at elevated risk regardless of acclimatization, given the duration and intensity of their exposure.

Hydration: Smarter Than You Think

For most people in the heat for under two hours, water is sufficient. Beyond that, electrolyte-containing drinks, as opposed to standard sports drinks, which are formulated for active sweat loss and carry excess sugar, are the better choice. Dangond’s practical rule: Pharmacy aisle electrolytes for general heat exposure, sports drink section for active athletic sweat loss.