What is the most likely cause of acute decompensation in a 19-year-old woman with preeclampsia (high blood pressure during pregnancy) and severe features, who develops hyperthermia (elevated body temperature), hypertension (high blood pressure), tachycardia (rapid heart rate), and respiratory distress after general anesthesia for an emergency cesarean delivery (surgical delivery of a baby)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 2, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis

  • Single most likely diagnosis
    • Malignant Hyperthermia: This is the most likely cause of the patient's acute decompensation. The symptoms of malignant hyperthermia, such as a rapid rise in temperature, hypertension, tachycardia, and muscle rigidity, are all present in this case. The triggering of malignant hyperthermia is often associated with the use of certain anesthetics, which this patient was exposed to during the emergency cesarean delivery.
  • Other Likely diagnoses
    • Anaphylactic reaction to anesthesia or other medications: Although less likely than malignant hyperthermia, an anaphylactic reaction could explain the patient's symptoms, including the rapid increase in temperature, blood pressure, and heart rate, as well as the difficulty in ventilation.
    • Preeclampsia with severe features exacerbation: The patient's underlying condition of preeclampsia with severe features could be contributing to her acute decompensation, particularly the hypertension and potential for multi-organ dysfunction.
    • Amniotic fluid embolism: This is a rare but serious condition that can occur during delivery, causing symptoms such as hypotension, hypoxia, and cardiac arrest, although the presentation may vary.
  • Do Not Miss diagnoses
    • Pulmonary embolism: Although less likely, a pulmonary embolism could cause sudden respiratory distress, hypoxia, and hemodynamic instability, making it a critical diagnosis not to miss.
    • Sepsis: Infection could be a cause of the patient's fever and hemodynamic instability, particularly in the context of a recent delivery and potential for postpartum complications.
  • Rare diagnoses
    • Thyrotoxic crisis: This is a rare but life-threatening condition that could cause symptoms such as hyperthermia, hypertension, and tachycardia, although it would be unusual in this context without a prior history of thyroid disease.
    • Neuroleptic malignant syndrome: This is another rare condition that could cause similar symptoms to malignant hyperthermia, although it is typically associated with the use of neuroleptic medications, which are not mentioned in this case.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.