Overview
Malignant hyperthermia is a severe reaction to certain drugs used for anesthesia, typically leading to a dangerously high body temperature, rigid muscles or spasms, a rapid heart rate, and other symptoms. This genetic disorder is caused by inherited mutations in the genes that regulate muscle function and sensitivity to certain anesthesia drugs. Without prompt treatment, the complications caused by malignant hyperthermia can be fatal. Symptoms may vary and can occur during anesthesia or during recovery shortly after surgery. Genetic testing can reveal whether an individual has an affected gene.
Understanding the disease
Symptoms
The symptoms of malignant hyperthermia include a dangerously high body temperature, rigid muscles or spasms, a rapid heart rate, and other symptoms.
Risk Factors
The risk factors for developing malignant hyperthermia include having a family history of the disorder and experiencing certain events or conditions, such as a history of suspected malignant hyperthermia during anesthesia, a history of muscle tissue breakdown called rhabdomyolysis, certain muscle diseases or disorders caused by inherited gene changes, and taking statin medications used to lower cholesterol. If one of your parents has the gene change that causes malignant hyperthermia, you have a 50% chance of inheriting the disorder.
Development
Malignant hyperthermia (MH) develops as a result of a genetic disorder called malignant hyperthermia susceptibility (MHS), which is caused by a gene change (mutation) in certain genes. These genes include RYR1, CACNA1S, and STAC3. When a person with MHS is exposed to certain anesthesia drugs that trigger a reaction, the body's muscles and organs experience abnormal functioning, leading to the symptoms of MH. MH can occur during anesthesia or recovery after surgery. Although there are some rare cases where MH may develop due to intense physical activity in hot and humid conditions, viral illnesses, or taking statin medication for cholesterol, these instances are less common.
Assessment and Diagnosis
Triage
If malignant hyperthermia is suspected, it is crucial to seek immediate medical attention as it is a severe reaction to certain drugs used for anesthesia. Delayed treatment can lead to severe complications or even death. If you notice symptoms such as a dangerously high body temperature, rigid muscles or spasms, a rapid heart rate, and other symptoms, contact a healthcare professional or visit the nearest emergency department for prompt assessment and treatment.
Diagnosis
Malignant hyperthermia is diagnosed based on signs and symptoms, monitoring during and immediately after anesthesia, and lab tests to identify complications. Susceptibility testing may be recommended to identify if you are at increased risk of malignant hyperthermia. This testing may include genetic testing or a muscle biopsy test. Genetic testing identifies the gene change that shows you have the genetic disorder called malignant hyperthermia susceptibility (MHS). If you have the genetic disorder MHS that puts you at risk of malignant hyperthermia, wearing a medical alert bracelet or necklace is recommended.
Management and Treatment
Complications
Potential complications of malignant hyperthermia include a rare condition that causes muscle cells to break down (rhabdomyolysis), kidney damage or failure, problems with clotting and bleeding, and death. If not treated promptly, these complications can arise due to the severe reaction to certain drugs used for anesthesia.
Home Remedies
It is important to seek prompt medical attention for malignant hyperthermia as it can be a life-threatening condition. Treatment typically involves medication, cooling measures, and supportive care provided by healthcare professionals.
Treatment
Treatments for malignant hyperthermia include the medication dantrolene (Dantrium, Revonto, Ryanodex), ice packs and other measures to cool body temperature, as well as supportive care.
Preparing for medical consultation
It's important to prepare for an appointment related to malignant hyperthermia by gathering relevant information and discussing any concerns with your healthcare provider. Here are some steps to help you prepare:
- Gather your medical history: Collect information about any previous episodes of malignant hyperthermia or related symptoms, surgeries, and any known family history of malignant hyperthermia or related genetic disorders.
- List your medications: Make a list of all the medications you are currently taking, including any over-the-counter drugs, supplements, or herbal products. Bring this list to your appointment, as it may help your healthcare provider identify any potential interactions or side effects.
- Prepare a list of questions: Compile a list of questions you may have for your healthcare provider, such as the latest treatment options, recommended precautions, or genetic testing options.
- Discuss your concerns: Be open with your healthcare provider about any fears, worries, or concerns you may have regarding your condition, treatment options, or potential risks.
- Bring along a family member: Consider bringing a family member or friend with you to the appointment, as they can provide additional support, help with remembering important information, and ask questions on your behalf. Remember to inform your healthcare provider and anesthesiologist about any suspected risks of malignant hyperthermia before undergoing anesthesia. This will help them make informed decisions regarding your anesthesia and any necessary precautions.