Probable Malignant Hyperthermia Presenting With Refractory Hypotension in a Young Trauma Patient: A Case Report

Malignant hyperthermia (MH) is a rare, life-threatening anesthetic complication caused by dysregulated skeletal muscle calcium homeostasis. We report a 25-year-old trauma patient who developed refractory hypotension with rising Etco2 despite progressive increases in minute ventilation, followed by hyperthermia, 2.5 hours after exposure to succinylcholine and sevoflurane. Hemodynamic instability was unresponsive to fluids and vasopressors but reversed rapidly after treatment for probable MH with dantrolene (Ryanodex). This case highlights early hemodynamic instability as a prominent manifestation of MH and emphasizes rising Etco2 despite increased ventilation as a critical diagnostic clue requiring prompt dantrolene administration.