Malignant hyperthermia: pathophysiology,
clinical presentation, and treatment

McCarthy EJ.
University of Maryland, School of Nursing,
Baltimore, USA.
AACN Clin Issues. 2004 Apr-Jun;15(2):231-7


Malignant hyperthermia (MH) was first described as an inherited highly lethal disorder in 1960. There has since been significant progress in the clinical management, identification of MH susceptible (MHS) persons, and understanding of the underlying pathophysiology. When patients are known to be MHS prior to surgery, an MH episode can easily be avoided by the use of safe nontriggering anesthetic agents. Current MH mortality is <10%, but many experts believe this can be significantly reduced by improved MH preparedness. MH is triggered in humans by an MH triggering anesthetic agent, which causes the release of calcium from the sarcoplastic reticulum of the skeletal muscle cell at an uncontrolled rate resulting in a hypermetabolic state. Recent molecular genetic studies have shown that MH is related to an abnormal ryanodine receptor that controls the release of calcium from the sarcoplastic reticulum. This article reviews the current understanding of the pathophysiology, diagnosis, clinical presentation, and treatment of MH.
Malignant hyperthermia
Contemporary anaesthesia
Anaesthesia and anaesthetics
Anaesthesia: rivalries and discoveries
Consciousness, anaesthesia and anaesthetics
First use of anaesthetics in different countries
Early religious/military opposition to anaesthetics

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