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The
next few slides illustrate the variable clincal presentation of MH. 4 different case
scenarios will be presented. Case One happened in the post anesthesia recovery room, where
the patient reported "feeling sick". Cardiac arrest then occurred. At that time
K+ was >10 mEq/l. Treatment included bicarbonate, epinephrine, calcium
chloride, dextrose & insulin. The patient's core temperature rose to 40° C. Ice packs
& cold intravenous fluids were administered. He developed acute renal failure.
Laboratory results included PT and PTT which were 3 to 4 min prolonged, platelet count was
<100,000/cc. Clinical coagulopathy did not develop. Dantrolene was not given. The
patient died of hyperkalemia the following day prior to institution of dialysis. Is this
MH or occult myopathy such as Becker's Muscular Dystrophy? |