This is a variant of postural hypotension resulting from the cumulative effect of peripheral vasodilation, decreased vasomotor tone, and relative volume depletion. It occurs most commonly in nonacclimatized individuals during the early stages of heat exposure. It does not necessarily represent a state of significant volume depletion.
Evaluation of patients with heat syncope requires the usual exclusion of neurologic, metabolic, and cardiovascular disorders. Patients should also be examined for any injuries acquired as a result of the syncopal episode and subsequent fall. Treatment consists of removal from the heat source, oral or intravenous rehydration, and rest. Hospitalization is usually not necessary. Most patients with heat syncope recover promptly with fluids.
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