Identification of Risk Factors for Exertional Heat Illness: A Brief Commentary on Genetic Testing

in Journal of Sport Rehabilitation
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Objective:

This commentary discusses known links between Exertional Heat Illness (EHI), Malignant Hyperthermia (MH), and other hereditary diseases of muscle. Genetic and functional testing is also evaluated as measures of fitness to return to duty/play.

Data Sources:

Reviews and research articles from Sports Medicine, Applied Physiology, and Anesthesiology.

Data Extraction:

Detailed comparisons of existing literature regarding clinical cases of EHI and MH and the potential utility of genetic testing, specifically the ryanodine receptor (RYR1) gene and other genes related to disorders of skeletal muscle.

Data Synthesis:

EHI is a complex disorder wherein physiological, environmental, and hereditary factors interact to endanger an individual’s ability to maintain thermal homeostasis.

Conclusions:

Individuals’ genetic background is likely to play an important role, particularly when EHI recurs. Recurrent EHI has been associated with MH and other genetic disorders, highlighting the importance of identification and exclusion of individuals with known high risk factors.

Sheila Muldoon is with the Department of Anesthesiology; Rolf Bunger is with the Department of Anatomy, Physiology, and Genetics; Patricia Deuster is with the Department of Military and Emergency Medicine; and Nyamkhishig Sambuughin is with the Department of Anesthesiology, all at the Uniformed Services University of the Health Sciences in Bethesda, MD. E-mail: smuldoon@usuhs.mil.