Key messages

• Malignant hyperthermia is thought to be caused by deregulation of Ca2+ homeostasis in skeletal muscle on exposure to triggering anesthetic agents, involving the mechanism of excitation-contraction coupling.

• The calcium channels of the triadic junction, the dihydropyridine and ryanodine receptors, are implicated in the etiology.

• Only 50 per cent of malignant hyperthermia families show genetic linkage to RYR1 (the ryanodine receptor).

• Marked genetic heterogeneity makes DNA testing for malignant hyperthermia dangerously unreliable at the present time.

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