Several people are susceptible to malignant hyperthermia and will exhibit symptoms of the disease. Basically, what will happen when this disorder occurs is that the body begins to overheat relatively quickly and will exhibit a panicked and unpleasant reaction from the patient. This condition is usually hidden and will usually make it present once anesthesia is introduced into the body. This condition is potentially fatal and can cause some severe damage to vital organs if repeated too many times.
Symptoms and Complications Related to Malignant Hyperthermia
Those who have malignant hyperthermia will usually not know until it occurs. The following symptoms and complications may make themselves present under the malignant hyperthermia condition:
Rise in Body Temperature – Can be easily seen when the body temperature rises up to 105 degrees or more very rapidly. This can usually be stopped with a cold blanket or other measures to lower the body temperature safely. This can usually be corrected on the operating table when it occurs due to the introduction of anesthesia.
Muscle Rigidity and Stiffness – The muscles will contract to the most extreme possible amounts and become rigid. This is abnormal especially when something like anesthesia is provided to patients that normally relax the body, the opposite effect is observed.
Very Dark and Brown Urine – Dark brown urine is usually observed when there are large amounts of extra dissolved materials in the urine. This can be an indicator of several problems but those who are susceptible to malignant hyperthermia will usually observe the dark colored or brown urine.
Muscular Aches and Pains – With malignant hyperthermia, muscular aches and pains can be present without the need to have exercised to be sore. This is damage on the muscular level caused by the malignant hyperthermia which can become a real problem for people.
Rhabdomyolysis – This is a condition in people with malignant hyperthermia that causes damage to the kidneys. This is usually caused by the extra myoglobin that causes the kidneys to overwork and strain to remove the excess. This can have a very damaging effect and cause the need to use a dialysis machine if the patient survives the malignant hyperthermia and catches the rhabdomuolysis in time.
Renal Failure – This is the sudden failure of the kidneys to remove wastes from the blood stream which will cause buildup of toxins that can be fatal if left to accumulate. This is a very serious condition which may require dialysis for the rest of the natural life of the patient if they survive the ordeal.
Myopathy – This is weakening of the muscles from the malignant hyperthermia which could stay. This is a very serious condition which could cause a person to be disabled with the inability to use their weakened muscles because of the disease.
Muscular Dystrophy – This condition causes weakness of the muscles and even reduces the muscle mass over time. This breakdown in the muscle tissue can be very damaging to the body and can cripple an individual when present. This can occur in people with malignant hyperthermia.
Death – Sudden death can occur from any of the previous symptoms and conditions, but malignant hyperthermia can cause a sudden death when anesthesia is introduces into the blood stream of the individual. Sometimes a revival from death is possible but very unlikely.
Causes of Malignant Hyperthermia
There is no definite way of telling whether or not someone has malignant hyperthermia, as it can occur through genetics or simply through conditional means. The condition is known to occur in people as an autosomal dominant trait. This is caused when only one parent has the gene, it has a very high likelihood of being passed on to the next generation and so forth. It is also possible to have malignant hyperthermia when a muscular disease is involved such as multiminicore myopathy or central core disease.
Certain defects in the genetic structure can also cause malignant hyperthermia. This has been found to occur when a defect of the RYR1 gene prevents the receptor for the ryanodine to not work correctly. This can be very difficult to deal with as it is something that is generally unavoidable as it is ingrained at the genetic level for malignant hyperthermia.
Who Can Have Malignant Hyperthermia
If there is one or more people that have had the malignant hyperthermia complications or have experienced sudden death when anesthesia was introduced, then it is possible to have the genes necessary to create malignant hyperthermia in the next generation or blood relatives. This is especially important information to give to a doctor if plans for surgery are scheduled as it could help save the life of the individual by not using certain types of anesthesia that are known to trigger a malignant hyperthermia episode. If the patient has some muscular diseases involved in their medical history, they may also be screened through various methods to determine the likelihood that they have malignant hyperthermia complications present.
Diagnostic Options for Malignant Hyperthermia
When those who are susceptible to the malignant hyperthermia complications need to learn if they may be affected, the following tests can help determine the possibility that it may occur:
Chem-20 – This is the comprehensive medical panel which will take blood serum and expose it to various elements and chemicals to determine what can negatively impact the patient. This can sometimes show changes in the blood serum when certain malignant hyperthermia reactive chemicals are introduced, hinting of the possibility of the disorder in the body.
RYR1 Gene Testing – This can be done with specialized tests that test for defects in the ryanodine receptors in the body. These results can help to prevent many of the complications that may occur from malignant hyperthermia by giving preventative measures to decrease the likelihood that it would make itself present during surgery.
Muscle biopsy – A muscle biopsy can be taken and exposed to anesthesia and observed. If there is a negative impact on the tissue sample, then an alternative treatment may be offered. This is a very important test if a susceptible malignant hyperthermia patient is at high risk and needs to have some sort of surgery that requires anesthesia.
Tests for Myoglobin in the urine – Myoglobin proteins occur in animals and cause the red pigmentation in muscle tissue. When the body is breaking down muscle during malignant hyperthermia, it releases the brown oxidized myoglobin through urine. This is a very possible indicator of malignant hyperthermia and can be the gateway to other tests to determine whether or not the patient is suffering the effects of malignant hyperthermia.
Treatment Options for Malignant Hyperthermia
Malignant hyperthermia has very few treatment options and they are not always successful in preventing the death of the patient. One of the only treatments that have an immediate effect is the muscle relaxant drug dantrolene. Dantrolene works by allowing muscle stiffness to reduce, body temperature to fall, and discontinues the triggering agents of malignant hyperthermia. The dantrolene can also help to reduce acidosis and organ dysfunction as soon as it is introduced into the body. The treatment has improved the mortality rate of malignant hyperthermia cases by 70% since the 1960s.
Another analogue treatment is the chemical Azumolene, which is 30 times more water soluble than dantrolene, which requires large amounts of liquid for treatment. Although Azumolene has not yet been tested on humans, swine test subjects that have exhibited the similar malignant hyperthermia symptoms and complications have shown promising results. This includes the reduction of intracellular calcium reduction during an episode of malignant hyperthermia. Azumolene has been shown to work just as well as dantrolene in swine subjects.
Preventative measures for malignant hyperthermia are highly recommended in those who are susceptible to the condition. The best prevention methods are to take dantrolene prophylactics to prevent the occurrence of malignant hyperthermia when anesthesia is introduced into the system. Another option is to use an alternative anesthesia that is not a triggering factor to malignant hyperthermia. The last preventative measure for malignant hyperthermia complications is to undergo surgery without the anesthesia in a last resort measure. Options such as nitrous oxide (laughing gas) are still useable as a safe alternative to intravenous anesthetics that do cause triggers of malignant hyperthermia.
General Outlook of Malignant Hyperthermia
Many of the people who are subject to the complications of malignant hyperthermia can live after their ordeal. A large amount of people will suffer kidney damage and other severe complications that may require special needs such as dialysis treatments to help them live. Those who take care of their bodies and prevent subsequent episodes of the condition have the highest outlook out of those who are affected by malignant hyperthermia. The best outlook is possible for those who take all of the measures needed to prevent malignant hyperthermia episodes by warning doctors and using alternatives to intravenous anesthetics.