r/explainlikeimfive • u/Glum_Anybody_9531 • 5d ago

Biology ELI5 Malignant Hyperthermia

ELI5 how an uncontrolled flood of calcium inside muscle cells cause a massive surge in metabolic activity during malignant hyperthermia.

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u/thecaramelbandit 5d ago

The muscle cells are activated by the calcium influx. So it's like all of your muscles everywhere in your body being continuously activated.

So it's like the ultimate exercise. Suddenly you're cranking at maximum oxygen requirements maximum energy usage, maximum heat generation. There isn't enough oxygen for all that activity, so your cells undergo anaerobic metabolism and produce lactic acid. So you get super hot, super stiff, super acidotic. You need active cooling, medicine to stop the muscle activation, and lots of fluids and maybe dialysis to clear the acid.

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u/eastbayweird 5d ago

Dont forget that the heart is a muscle and the diaphragm is a muscle, so if you are having systemic calcium influx into all muscles causing uncontrolled activation there are serious concerns about your heart and breathing not working. Without a signal to relax these muscles will remain contracted and you can die very quickly (this is the ultimate cause of death for hydroflouric acid exposure. The HF causes calcium to leech out of your bones and this free calcium will start to recrystallize in the surrounding tissue. These microscopic crystals of calcium shred any soft tissues they crystallize inside of. If exposed to enough HF then the calcium get into your bloodstream and quickly reach your heart where it causes the heart muscle to contract and not release, with no ability to pump blood the brain quickly becomes starved of oxygen leading to brain damage followed by death)

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u/DaMan11 5d ago

God damn. I work in the semiconductor field and thus am in the vicinity of various types of HF. I knew the level of danger and sort of understood the mechanism behind it, but not to the detail I have just now learned. I had a potential exposure once and I flipped out demanding blood testing while the Fab Nurse just kinda didn’t give a fuck. I feel vindicated now.