SUPRAVENTRICULAR TACHYCARDIA FOLLOWING SECOND INDUCTION OF ANESTHESIA IN A PATIENT DIAGNOSED AS MALIGNANT HYPERTHERMIA AFTER FIRST ANESTHETIC EXPOSURE: TERMINOLOGY REQUIRES A SECOND LOOK

A 17 year old male who underwent surgery for thoracic outlet syndrome developed a postoperative complication which was labelled and diagnosed as malignant hyperthermia in Kerman Medical Center. The temperature recorded was 43°C, PaC02 70 mmHg and serum potassium level was 7 mEq/L. The patient was hospitalized in the intensive care unit for 10 days. On discharge, the patient had aphasia and incoordination in gait. Gradually the symptoms improved. However dysarthria, a reduction in muscle force and a staggering gait persisted. The same patient underwent a second operation for a spinal cord tumor located in the cervical region at this center. Following induction of anesthesia, the pulse rate showed a stepladder rise reaching a peak: of 198 per minute. Except for a rapid heart rate, the patient had an uneventful operative course and a speedy recovery following the operation without any sequelae. The case is being reviewed and the plethora of diverse symptomatology and clinical picture explored to highlight the controversy of malignant hyperthermia in this particular case.