Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
UCHOA, Ricardo Barreira and FERNANDES, Cláudia Regina. Exercise-induced rhabdomyolysis and risk for malignant hyperthermia: case report. Rev. Bras. Anestesiol. [online]. 2003, vol.53, n.1, pp. 63-68. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942003000100009.
BACKGROUND AND OBJECTIVES: Rhabdomyolysis is a skeletal muscle injury with cell components' release to plasma. Exhaustive exercise, especially in non-conditioned individuals, may result in severe morbidity such as hyperkalemia, metabolic acidosis, disseminated intravascular coagulation, acute respiratory distress syndrome and rhabdomyolysis. It has been suggested that malignant hyperthermia, thermal shock and exercise-induced rhabdomyolysis are closely related syndromes. This report aimed at describing a case of fatal rhabdomyolysis after physical exercise and its correlation with malignant hyperthermia. CASE REPORT: Male patient, 32 year-old, presented with discomfort followed by syncope after running 2,350 m in a fitness race. Patient was taken to the hospital, evolved with respiratory failure, bradyarrhythmia, arterial hypotension and cardiac arrest, being resuscitated. Nevertheless, patient became comatose with severe muscle stiffness, persistent shock, coagulation problems, metabolic acidosis, hyperkalemia and died less than 24 hours later. Autopsy findings revealed rhabdomyolysis-induced acute pulmonary edema, disseminated intravascular coagulation and acute renal failure. CONCLUSIONS: It has been suggested that malignant hyperthermia and exercise-induced rhabdomyolysis are closely related syndromes. Patient died before any specific investigation of malignant hyperthermia, but it is important to look for susceptibility for this syndrome within the family to avoid potentially life-threatening anesthetic events.
Keywords : COMPLICATIONS [malignant hyperthermia].