Which finding during anesthesia planning indicates a malignant hyperthermia risk?

Which finding during anesthesia planning indicates a malignant hyperthermia risk?

• A. Family history of anesthesia fever
• B. Prior asthma
• C. Previous DVT
• D. Allergy to penicillin

Answer: (A)

When assessing malignant hyperthermia risk, a positive family history of an anesthesia-related hypermetabolic crisis is the strongest clue. Malignant hyperthermia is a genetic condition that causes the muscles to release calcium uncontrollably when exposed to triggering agents used in anesthesia, such as certain inhaled anesthetics and depolarizing muscle relaxants. This susceptibility is inherited, often in an autosomal dominant pattern, so knowing that relatives have had anesthesia-induced hyperthermia or MH reactions flags a real risk for the patient. If there is such a family history, the anesthesia plan should avoid triggering agents and prepare for MH management: use non-triggering drugs (for example, total intravenous anesthesia with propofol, non-depolarizing neuromuscular blockers), ensure dantrolene is readily available, and set up careful intraoperative monitoring of end-tidal CO2, temperature, heart rate, and muscle tone so any early signs can be detected quickly. The other options—asthma, prior DVT, or penicillin allergy—do not indicate MH susceptibility, as they are unrelated to the genetic calcium-handling defect that drives MH.

When assessing malignant hyperthermia risk, a positive family history of an anesthesia-related hypermetabolic crisis is the strongest clue. Malignant hyperthermia is a genetic condition that causes the muscles to release calcium uncontrollably when exposed to triggering agents used in anesthesia, such as certain inhaled anesthetics and depolarizing muscle relaxants. This susceptibility is inherited, often in an autosomal dominant pattern, so knowing that relatives have had anesthesia-induced hyperthermia or MH reactions flags a real risk for the patient.

If there is such a family history, the anesthesia plan should avoid triggering agents and prepare for MH management: use non-triggering drugs (for example, total intravenous anesthesia with propofol, non-depolarizing neuromuscular blockers), ensure dantrolene is readily available, and set up careful intraoperative monitoring of end-tidal CO2, temperature, heart rate, and muscle tone so any early signs can be detected quickly. The other options—asthma, prior DVT, or penicillin allergy—do not indicate MH susceptibility, as they are unrelated to the genetic calcium-handling defect that drives MH.