Which statement about malignant hyperthermia risk is true?

• A. It is a common complication
• B. It is rare but can be life-threatening
• C. It occurs with all anesthetics
• D. It is easily treated with antihistamines

Answer: (B)

The risk of malignant hyperthermia is rare but can be life-threatening. It’s a genetic disorder of skeletal muscle calcium handling that is triggered by certain anesthetics (like volatile inhaled agents) and sometimes the depolarizing muscle relaxant succinylcholine. In susceptible individuals, these triggers cause uncontrolled calcium release from the sarcoplasmic reticulum, leading to rapid and extreme muscle metabolism, rigidity, overheating, acidosis, and potential organ failure if not treated quickly. Because of the potential severity, it’s treated as an emergency: stopping the triggering agent, administering dantrolene (which blocks calcium release from the sarcoplasmic reticulum), cooling the patient, and providing supportive care. Importantly, MH does not occur with all anesthetics—there are non-triggering agents that are considered safe for susceptible patients. Antihistamines do not treat malignant hyperthermia; they’re for allergic reactions, not this metabolic crisis.