Despite the inherent usefulness of anesthesia, it is unfortunate that unpredictable complications often compromise patient safety. What if simple genetic testing could transform the unforeseeable into something manageable?

What Is Malignant Hyperthermia?

This condition may manifest after the administration of certain anesthetics or other medications, and it can raise a patient’s temperature to a fatal level. It may also lead to tissue damage. As with general hyperthermia, presenting signs of MH may include rapid/irregular heartbeat, muscle spasms, skeletal muscle rigidity, high fever, extreme sweating, and very high body temperature.

What Might Trigger This Condition?

Malignant Hyperthermia can be triggered by any of the following:

  • Inhaled general anesthesia
  • Sevoflurane
  • Succinylcholine
  • Desflurane
  • Methoxyflurane
  • Enflurane
  • Ether
  • Halothane
  • Isoflurane

Unfortunately, prior use of these anesthetics without complications does not indicate a lack of future risk. Generally, no symptoms or signs of susceptibility will appear in advance of exposure to certain anesthesia drugs.

How Is It Related to Genetics?

There are over 80 genetic defects that are typically familial and can cause malignant hyperthermia. These DNA defects may appear at birth or activate in a patient’s later years. In addition, random genetic defects can also cause MH.

How Is It Related to Genetics?

While not 100% accurate, genetic blood testing can identify a defect that appears in about half of the population that is susceptible to MH. Some people with this anomaly may not develop the condition; malignant hyperthermia may also be triggered in patients with genetic defects not yet discovered.

However, a physician armed with these test results is well-prepared to safeguard patient safety.

Additionally, any patient unaware of possible familial or personal defects may be informed that people with the condition do have a 50% chance of passing it to their children. Only one parent needs the gene defect to hold a 50% chance of passing it to offspring.

If a patient’s other relatives have this genetic disorder, the patient’s odds of having the defect increase.

How Is It Prevented or Treated?

Drugs that do not trigger MH may be chosen by the physician. Should the condition manifest, the use of the triggering medication must cease immediately. Additional treatment steps may include but are not limited to:

  • Oxygen administration
  • Use of a cooling blanket or fan with cool mist
  • Ice packs applied to the groin, underarms, or other areas
  • IV administration of cold fluids or additional fluids
  • Dantrolene (Dantrium, Ryanodex, Revonto) injection to prevent calcium release into muscle
  • Administration of other medications to correct a metabolic imbalance
  • Calling a malignant hyperthermia hotline
  • Intensive care monitoring to track treatment response
  • Lab testing to identify muscle breakdown or kidney damage

Are There Possible Complications With Malignant Hyperthermia?

Untreated MH can result in:

  • Breakdown of muscle tissue and subsequent release into blood (rhabdomyolysis)
  • Kidney failure or damage
  • Clotting/bleeding problems
  • Death

Considering the high number of complications that appear unexpectedly during or after anesthesia administration, it is important for the health and safety of the patient population to identify potential risks in advance. Genetic testing for conditions like malignant hyperthermia is highly valuable.

Contact us to explore this useful option.