Suspected Malignant Hyperthermia in a Patient Undergoing Cardiac Surgery: Perioperative Challenges and Management

Malignant hyperthermia (MH) is a rare but potentially fatal disorder characterized by a hypermetabolic state produced by exposure to triggering agents such as volatile anesthetics and succinylcholine.1, 2 MH crises have also been recognized in the absence of exposure to obvious triggers. The incidence of MH may range from 1:5,000 to 1:100,000 anesthetic administrations, although the prevalence of predisposing genetic lesions is likely as common as 1 in every 3,000 individuals.1 Clinically, MH presents with a constellation of signs and symptoms including muscle rigidity, hypercarbia, tachycardia, acidosis, and hyperthermia, which if not promptly recognized and managed with dantrolene, is likely to lead to significant morbidity or death.