A narrative review on pathophysiology, health complications, and emergency management of heatstroke in Pakistan

Background: Global warming and frequent heat waves are serious public health challenges, posing escalating health risks to human beings. Exposure to hot environment leads to heat-related illness, whose deadliest form is heatstroke which is an emergency condition in which body temperature exceeds 40 °C. The present review aims to consolidate available literature about pathophysiology, health complications, and stepwise management of heatstroke.Methods: A narrative assessment of peer reviewed literature was carried out to provide up-to-date facts and figures about heatstroke from 20th August 2025 to 5th September 2025. The relevant studies were searched across Scopus, PubMed, Wiley Online Library, and Google Scholar without any time limit. Peer reviewed, full-text and English language research and review publications were included in the study.Results: The pathophysiological mechanism of heatstroke involves an imbalance between heat production and its dissipation due to failure of thermoregulation, involving a series of events both intracellular and extracellular. These persistent conditions result in widespread cell death, electrolyte imbalance, liver and renal injury, coagulation, and mental status alteration. If immediate actions are not taken, coma, severe hypotension, shock, cardiac arrest, and even death may occur. The management of heatstroke involves early recognition and first aid, management in the emergency department, and supportive care in intensive care unit. Conclusion: Heatstroke is a life-threatening condition that can be prevented by adopting a holistic approach, involving early warning system, establishing cooling centres during hot weathers, awareness campaigns, occupational safety measures, urban planning, and planting trees on large-scale.