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Malignant hyperpyrexia is a life-threatening condition caused by exposure to general anesthesia or extreme stress. Symptoms include rapid heart and respiratory rate, muscle stiffness, and high temperature. Treatment includes dantrolene sodium and cooling blankets. It is a genetic condition, and avoiding general anesthesia is the only way to prevent future problems. Local anesthetics and opiates do not trigger the condition.
Malignant hyperpyrexia is a potentially life-threatening condition that develops in people exposed to drugs for general anesthesia. Less commonly, someone can develop the condition due to stress from exercise or exposure to extreme heat. The condition is also known as malignant hyperthermia or malignant hyperthermia syndrome.
Anesthetic drugs overwhelm the circulatory system of individuals who have malignant hyperpyrexia. Stress on the circulatory system can lead to death if not treated immediately. Symptoms of malignant hyperpyrexia include a rapid heart rate and respiratory rate, increased carbon dioxide production and oxygen consumption, muscle stiffness, a high temperature above 105 degrees Fahrenheit (40.5 C), an increase in the acidity of the blood, and a rapid breakdown of muscle tissue.
Symptoms of malignant hyperpyrexia develop rapidly after exposure to anesthesia, usually within an hour, although in rare cases it may take several hours for symptoms to develop. Treatment with dantrolene sodium may reverse symptoms. Dantrolene sodium is also given to people who are at risk of developing malignant hyperpyrexia but who need general anesthesia for surgery; this usually prevents the onset of symptoms. Additional treatment includes a cooling blanket to lower the temperature and the introduction of intravenous and oral fluids to prevent kidney damage. Repeated incidences, even if treated quickly, can lead to kidney failure.
Malignant hyperpyrexia is a genetic condition, and having one family member with the condition increases the likelihood that others will have the condition. Only one parent needs to carry the gene for malignant hyperpyrexia to pass on the trait. Avoiding general anesthesia is the only way to prevent future problems.
Any cases of unexplained death under anesthesia in the family should be discussed with a healthcare professional before undergoing general anesthesia. Additionally, anyone with a family history of muscular dystrophy or myopathy should consider genetic counseling before receiving general anesthesia. It is estimated that 1 in 100,000 people may have this condition. The mortality rate is about six percent.
It is important to note that general anesthesia drugs, especially the combination of anesthetic agents and neuromuscular blocking drugs, create the problem. Local anesthetics, such as lidocaine and opiates, such as morphine, do not trigger this condition. Individuals who may have the genetic trait for malignant hyperpyrexia should, however, avoid cocaine, ecstasy, amphetamines and other stimulants, which can trigger similar symptoms.
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