Hipertermia severa post cirugía cardiaca: presentación de un caso

introduction: malignant hyperthermia is a hereditary myopathy caused by a rianodine receptor disorder of rugous sarcoplasmic reticulum of the skeletal muscle becomes clear in patients oversensitive to exposition to halogen agents or to succinylcholine. objective: to present the course of patient presenting with a severe hyperpyrexia after a heart surgery. clinical case: patient aged 56 programmed for an aortic valvular replacement, asa iii, functional class nyha-ii-iii without other backgrounds. at her arrival to postperative intensive care unit (poicu) it was noted a significant widespread muscular contracture mainly in masseter muscles, a progressive increase of the arterial co2 (105 mm hg), metabolic acidosis, low pao2/fio2 relations, urine of red wine color, hyperpotassemia, sinus tachycardia with frequent early ventricular contractions, self-limited of ventricular tachycardia, a sever and low cardiac output and sustained hyperpyrexia if 41°c taking measures related to symptoms. at 8 hours fever decreased with restoration of internal environment, urine color cleared, hemodynamics was stable verifying a rise of serum creatinine which decreased progressively after few days. at 48 hours patient was weaned of the mechanical ventilation. at 5 days she was discharged from the poicu. conclusions: apart from there were not specific tests to malignant hyperthermia, it is a complex case presenting with a severe hyperpyrexia and a satisfactory course.