There is nothing worse than a sudden death of a healthy patient during surgery. In this day and age a tragedy of those proportions is downright unbelievable. However, the threat of sudden death is still very real when dealing with a patient who is prone to anesthesia hyperthermia syndrome, which is another name for malignant hyperthermia (MH). Even when treated correctly, this so called MH crisis has the potential to cause death, and in rare occurrences leave patients with failing kidneys, brain damage, or other critical organs damaged.
Another cause, not to be mistaken for malignant hyperthermia, but can also cause sudden death to occur would be a cardiac arrest by a male that suffers from muscular dystrophy. Especially with young patients the signs of muscular dystrophy often do not manifest themselves as such and therefore the anesthesia care team may not be aware of this fact which can result in an increase of potassium in the bloodstream when put under, leading to enough of the substance to stop the heart. This phenomenon occurs using the same anesthetic drugs that can trigger malignant hyperthermia but the cause is completely different and not related. Signs of muscular dystrophy would be severe degeneration of the muscles which shows itself through brown urine and failure of the kidneys.
Malignant hyperthermia is a response induced by common anesthetics as they are used in almost every hospital in combination with succinylcholine, which is a paralyzing agent. Malignant hyperthermia manifests itself within the skeletal muscles of people that are prone to it. Warning signs of this condition manifesting are increased body metabolism, muscle stiffness, and fevers over 110 degrees Fahrenheit. Malignant hyperthermia can cause severe complications during surgery, among them; cardiac arrest, brain damage and failure of vital body organs.
Over the years our knowledge about the causes of malignant hyperthermia has improved significantly. In order to determine who is prone to such a condition, more than eighty genetic problems have been identified as being associated with malignant hyperthermia. It is possible to inherit susceptibility to malignant hyperthermia. Patients where this condition runs in the family have a 50% chance of inheriting the same genetic problems that can trigger MH.
It is also important to note that a person who inherited one of the gene problems associated with MH, might never develop the condition. In most cases the person is unaware of the risk, unless it has occurred before in the family. Nevertheless MH is still a very real threat and the anesthesia care team needs to be aware of while a patient is undergoing surgery.
