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June 27, 1986

Malignant Hyperthermia

Author Affiliations

Texas Tech University Health Sciences Center El Paso

JAMA. 1986;255(24):3362-3363. doi:10.1001/jama.1986.03370240032017

To the Editor.—  A recent article in MEDICAL NEWS & PERSPECTIVES entitled "Malignant Hyperthermia: Nightmare for Anesthesiologists—and Patients"1 presents a one-sided and inaccurate view of the basic fundamental genetic defect that causes malignant hyperthermia (MH).My laboratory has been using a colony of MH-susceptible pigs as an animal model for MH studies for the past 16 years. Our most recent experimental data clearly demonstrate that a 100- to 300-fold increase of plasma norepinephrine (up to 108 ng/mL) precedes by five to ten minutes the development of the classic MH syndrome symptoms.2 We have also published data showing that an intense peripheral vasoconstriction and severe hypertension are also part of the MH syndrome.3-6 The vasoconstriction is so severe that heat loss via radiation from the skin is completely shut down. The severe hypertension (>400 mm Hg), intense peripheral vasoconstriction, and severe tachycardia (>180 beats per minute) that develop