====== Malignant hyperthermia clinical features ====== 1. earliest possible sign: increase in end-tidal pCO2 2. tachycardia (early) and other arrhythmias 3. with progression: a) coagulation disorder (DIC) (bleeding from surgical wound and body orifices) b) ABG: increasing metabolic acidosis & decreasing pO2 c) pulmonary edema d) elevated body temperature (may reach ≥ 44 °C (113 °F) at rate of 1 °C/5‑min) (normal patients become hypothermic with general anesthesia) e) limb muscle rigidity (common, but late) f) [[rhabdomyolysis]] → elevated CPK & myoglobin (late) 4. terminal: a) hypotension b) bradycardia c) [[cardiac arrest]] ---- Classical manifestations comprise of tachycardia, increase in expired carbon dioxide levels, muscle rigidity, hyperthermia (>38.8°C) and unexpected acidosis ((Rosenberg H. Clinical presentation of malignant hyperthermia. Br J Anaesth. 1988;60:268–73. )).