Heat Exhaustion vs. Heat Stroke: How to Tell the Difference This Summer

Summer in Nebraska brings plenty of sunshine, but it also brings rising temperatures that can be hard on your body. Whether you're gardening in Gretna or walking the trails in Omaha, it's vital to know when the heat's become more than just a nuisance. When your body can't cool itself down fast enough, you risk developing hyperthermia—a condition where your internal temperature rises to dangerous levels. 

At Midwest Regional Health Services, our team wants you to stay safe while enjoying the outdoors. Understanding the difference between heat exhaustion and heat stroke can save a life, as one is a warning sign and the other is a true medical emergency. Here's what you need to look for and how to protect yourself.

What's the difference between heat exhaustion and heat stroke?

The main difference between the two is how your body is responding to the heat. Heat exhaustion happens when your body's cooling system is struggling, while heat stroke happens when that system has completely failed. 

If you have heat exhaustion, you'll likely feel heavy sweating, dizziness, nausea, and a weak, rapid pulse. You might feel faint or have muscle cramps. If you notice these signs, you should move to a cool place, drink water, and rest immediately. However, if these symptoms aren't addressed, they can quickly progress to heat stroke.

Heat stroke is a life-threatening emergency where "time is tissue," meaning every minute of high heat causes more damage to your organs. The telltale sign is a change in your mental status—a quick way to see if the brain is functioning normally. You can check this by asking simple questions like, "What's your name?" or "What day is it?" If the person is confused, slurring their speech, or acting agitated, call 911 right away. You should also look for a lack of sweating, even though it's hot, and a very high body temperature.

Why your health history matters in the heat

It's not just the temperature outside that matters; it's also how your body handles it. Your heart bears the brunt of the heat because it has to work much harder to pump blood to the skin's surface for cooling. According to the American Heart Association (AHA, 2024), the combination of extreme heat and air pollution can actually double the risk of a fatal heart attack. This makes primary care and chronic disease management especially important during the summer months.

Certain medications can also interfere with your thermoregulation—the body's ability to control its internal temperature. These drugs can make you more susceptible to the heat without you even realizing it. Common medications that increase your risk include:

• Diuretics: Often called water pills, these can lead to faster dehydration.
• Beta-blockers: These can reduce the heart's ability to pump enough blood to the skin for cooling.
• Psychiatric medications: Some antidepressants can inhibit your natural sweating mechanism.
• ADHD Stimulants: These can increase your baseline heart rate and internal heat.
• GLP-1 Agonists: These newer weight loss and diabetes meds can suppress your natural thirst cues.

It's also important to remember that tools we often rely on might not always work as expected. For example, electric fans provide no physiological cooling relief for older adults in extreme indoor heat and can actually act like a convection oven, raising body temperature further (ScienceDaily, 2025).

If you're concerned about how your current medications or health conditions might affect you this summer, we're here to help. Our team can review your "hot day plan" and ensure you're taking the right precautions. Contact Midwest Regional Health Services to schedule an appointment at our Omaha or Gretna offices today.