Malignant Hyperthermia: Report of Two Cases with a Neglected Complication in Cardiac Surgery
Malignant hyperthermia (MH) can develop after contact with volatile anesthetics (halothane, enflurane, isoflurane, sevoflurane, and desflurane) as well as succinylcholine and cause hypermetabolism during anesthesia, which is associated with high mortality when untreated. Early diagnosis and treatmen...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2018-02-01
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| Series: | Journal of Tehran University Heart Center |
| Subjects: | |
| Online Access: | https://jthc.tums.ac.ir/index.php/jthc/article/view/495 |
| _version_ | 1811280125248929792 |
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| author | Mahdi Neshati Manizheh Azadeh Parinaz Neshati Tyrone Burnett Ryan Saenz Bahman Karbasi Ghader Shahmohammadi Eskandar Nourizadeh Mohsen Rostamzadeh |
| author_facet | Mahdi Neshati Manizheh Azadeh Parinaz Neshati Tyrone Burnett Ryan Saenz Bahman Karbasi Ghader Shahmohammadi Eskandar Nourizadeh Mohsen Rostamzadeh |
| author_sort | Mahdi Neshati |
| collection | DOAJ |
| description | Malignant hyperthermia (MH) can develop after contact with volatile anesthetics (halothane, enflurane, isoflurane, sevoflurane, and desflurane) as well as succinylcholine and cause hypermetabolism during anesthesia, which is associated with high mortality when untreated. Early diagnosis and treatment could be life-saving. During cardiac surgery, hypothermia and cardiopulmonary bypass make the diagnosis of MH extremely challenging compared with other settings such as general surgery.
We herein report 2 cases of MH, graded as “very likely” or “almost certain” based on the MH clinical grading scale. A 14-month-old infant and a 53-year-old male underwent surgery for severe pulmonary valve stenosis and mitral valve replacement, respectively. Both of them were extubated on the operation day, but they deteriorated with the development of high-grade fever, hypotension, renal failure, and acidosis. The first case had muscle spasms. Unfortunately, the delayed symptoms of MH in the early postoperative course were not diagnosed in these 2 cases, which caused permanent neurologic damage in the first case and death in the second one. However, the infant was discharged from the hospital after 2 months. |
| first_indexed | 2024-04-13T01:07:51Z |
| format | Article |
| id | doaj.art-9c6c115ed7684b4b81e43a67dbb3c38f |
| institution | Directory Open Access Journal |
| issn | 1735-8620 2008-2371 |
| language | English |
| last_indexed | 2024-04-13T01:07:51Z |
| publishDate | 2018-02-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Tehran University Heart Center |
| spelling | doaj.art-9c6c115ed7684b4b81e43a67dbb3c38f2022-12-22T03:09:16ZengTehran University of Medical SciencesJournal of Tehran University Heart Center1735-86202008-23712018-02-01124492Malignant Hyperthermia: Report of Two Cases with a Neglected Complication in Cardiac SurgeryMahdi Neshati0Manizheh Azadeh1Parinaz Neshati2Tyrone Burnett3Ryan Saenz4Bahman Karbasi5Ghader Shahmohammadi6Eskandar Nourizadeh7Mohsen Rostamzadeh8Department of Cardiothoracic Surgery, Ostad Aalinasab Hospital, Tabriz, Iran.Institute of Clinical Evaluative Sciences (ICES), Sunnybrook Hospital, University of Toronto, Toronto, Canada.Greater Houston Interventional Pain Associates, Houston, USA.Department of Anesthesiology, University of Texas Health Science Center, Houston, USA.Department of Anesthesiology, University of Texas Health Science Center, Houston, USA.Department of Cardiothoracic Surgery, Ostad Aalinasab Hospital, Tabriz, Iran.Department of Cardiothoracic Surgery, Ostad Aalinasab Hospital, Tabriz, Iran.Department of Cardiothoracic Surgery, Ostad Aalinasab Hospital, Tabriz, Iran.Department of Cardiothoracic Surgery, Ostad Aalinasab Hospital, Tabriz, Iran.Malignant hyperthermia (MH) can develop after contact with volatile anesthetics (halothane, enflurane, isoflurane, sevoflurane, and desflurane) as well as succinylcholine and cause hypermetabolism during anesthesia, which is associated with high mortality when untreated. Early diagnosis and treatment could be life-saving. During cardiac surgery, hypothermia and cardiopulmonary bypass make the diagnosis of MH extremely challenging compared with other settings such as general surgery. We herein report 2 cases of MH, graded as “very likely” or “almost certain” based on the MH clinical grading scale. A 14-month-old infant and a 53-year-old male underwent surgery for severe pulmonary valve stenosis and mitral valve replacement, respectively. Both of them were extubated on the operation day, but they deteriorated with the development of high-grade fever, hypotension, renal failure, and acidosis. The first case had muscle spasms. Unfortunately, the delayed symptoms of MH in the early postoperative course were not diagnosed in these 2 cases, which caused permanent neurologic damage in the first case and death in the second one. However, the infant was discharged from the hospital after 2 months.https://jthc.tums.ac.ir/index.php/jthc/article/view/495Acute kidney Injury • Coronary artery bypass • Risk factors |
| spellingShingle | Mahdi Neshati Manizheh Azadeh Parinaz Neshati Tyrone Burnett Ryan Saenz Bahman Karbasi Ghader Shahmohammadi Eskandar Nourizadeh Mohsen Rostamzadeh Malignant Hyperthermia: Report of Two Cases with a Neglected Complication in Cardiac Surgery Journal of Tehran University Heart Center Acute kidney Injury • Coronary artery bypass • Risk factors |
| title | Malignant Hyperthermia: Report of Two Cases with a Neglected Complication in Cardiac Surgery |
| title_full | Malignant Hyperthermia: Report of Two Cases with a Neglected Complication in Cardiac Surgery |
| title_fullStr | Malignant Hyperthermia: Report of Two Cases with a Neglected Complication in Cardiac Surgery |
| title_full_unstemmed | Malignant Hyperthermia: Report of Two Cases with a Neglected Complication in Cardiac Surgery |
| title_short | Malignant Hyperthermia: Report of Two Cases with a Neglected Complication in Cardiac Surgery |
| title_sort | malignant hyperthermia report of two cases with a neglected complication in cardiac surgery |
| topic | Acute kidney Injury • Coronary artery bypass • Risk factors |
| url | https://jthc.tums.ac.ir/index.php/jthc/article/view/495 |
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