Essay on Malignant Hyperthermia

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Malignant Hyperthermia

Abstract
A patient, waiting to undergo his cardiac surgery, is lying on a surgical platform. An anesthesiologist enters the surgical room and injects some general anesthetics into the patient’s bloodstream. The patient appears normal until after a few minutes, the patient suddenly experiences increasing body temperatures leading to a high fever, muscle rigidity, and increased heart rate. The anesthesiologist is perturbed, runs out of the surgery room, and alerts the surgical staff of the patient’s alarming symptoms. The surgical staff identifies the symptoms as Malignant Hyperthermia. What exactly is
Malignant Hyperthermia and how is it caused? Malignant Hyperthermia, a rare skeletal muscular disease
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[2] Temperature can rise 1 C for every 5 minutes; hence, the word hyperthermia is included in disease’s name. [3] If not treated immediately, death is a possible consequence.
Before we discuss the causes of malignant hyperthermia, we must first understand some background information about calcium ion channels and the path the calcium ions involved travel during muscle contraction.
For this process, refer to figure 1. First, an action potential (nerve impulse) from a sodium/potassium channel is triggered. [4] The action potential reaches the T-tubule. [4]. The T tubule (traverse tubule) is a deep fold of the cell membrane that contains many L-type calcium channels (also known as Dihydropyridine receptors). [6] L-type calcium channels are voltage-gate channels that regulate the flow of Ca2+. [6] The action potential causes an electrical difference near the L-type calcium channels and activates them. [3] As a result, the L-type calcium channels open and allow Ca2+ ions to flow into the cell. Notice from figure 1, there is a gap between the T tubule and the sarcoplasmic reticulum, a type of smooth endoplastic reticulum organelle involved in pumping calcium ions and is a storage room for the Ca2+ ions. [4] How can Ca2+ ions cross this gap? Studies show that the L-type calcium channel contains many subunits, as seen in figure 2. One

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