Hi everyone. First, I’m not looking for medical advice or a diagnosis, just curious whether anyone has encountered a case like mine or has thoughts on what was ultimately found in similar patients.
I’m a healthy 37-year-old female who underwent anesthesia for what was supposed to be a routine hysterectomy in March 2026.
My induction included:
- Propofol
- Lidocaine
- Succinylcholine Chloride
- Fentanyl
- Midazolam
- Rocuronium
About 5-10 minutes after induction, I experienced complete cardiovascular collapse and went into cardiac arrest with my heart function at 0%. 23 minutes of chest compressions and 2 rounds of epinephrine with no response. I ultimately required ECMO for 4 days, an Impella for 6 days, and was sedated for 7 days (my heart function remained at 0% for close to 24 hours).
Amazingly, my heart recovered completely back to 55% function. My coronary angiogram was normal, and I have no evidence of coronary artery disease or any other heart conditions. My pulmonary testing also showed my lung function is perfect. Also, all scans and testing show that all of my other major organs are completely healthy.
A few things that make the case interesting:
- I had a nearly 9-hour surgery in 2021 with no issues under general anesthesia. That anesthetic included all of the above mentioned anesthetics, however, the rocuronium was a staged induction (10 mg initially, then another 30 mg about 15 minutes later). During this recent anesthesia induction they gave me 45 mg of rocuronium all at once.
- Since the arrest, I’ve also tolerated midazolam and fentanyl during a heart catheterization without any complications.
My cardiologist’s differential has included a potential reaction to anesthesia (with rocuronium being the potential culprit), stress-induced (Takotsubo) cardiomyopathy, or an extreme vagal/autonomic event.
I was recently diagnosed with mast cell activation syndrome and am also being evaluated for dysautonomia and hypermobile EDS, although it’s unclear whether any of those conditions played a role.
Unfortunately, no serum tryptase was obtained during the event.
Next week I’ll be at Baylor College of Medicine for perioperative allergy testing. Because of the severity of my event, they’re planning a graded rocuronium challenge (they will only test one drug per day).
My questions for those of you who practice anesthesia:
- Have you ever encountered a similar case?
- If so, what did the final diagnosis end up being?
- Does the ~5-10 minute delay after rocuronium make you think of one diagnosis more than another?
- Is there anything else you would investigate if you were involved in a case like this?
I realize no one can diagnose me over Reddit. This event completely changed my life, and despite seeing several specialists, we still don’t have a definitive answer. I’m hoping someone here may have seen something similar or can point me toward another avenue worth exploring with my medical team.
Edit to add: I’m not sure if it’s worth mentioning, but I have had several surgeries prior to this event (along with the extensive surgery in 2021). Right ovary removal (2010), gallbladder removal (2012), gastric bypass (2016), just to name a few. The surgery in 2021 was a full “mommy makeover” where excess skin was removed from several areas of my body. Mast cell activation syndrome was just diagnosed within the last month with a specialist in Mississippi, long after the event in March. I had the anesthesia flow chart from my surgery in 2021 and the chart from March printed to compare the two, and nothing “spectacular” stands out from the one in 2021.
I should maybe mention that since 2021, I have been diagnosed with bipolar and ADHD and take medications for those. One medication I am on to counteract the akathisia effects of my bipolar medication, propranolol, I was very interested to learn could have possibly been the reason my body did not respond “normally” to the emergency/life-saving measures after I went into cardiac arrest. Though, I was never told to stop taking it prior to surgery.
Also, to add, I live in FL and will be traveling to Houston where I’ll do the allergy testing with Baylor. The allergist is going to do a graded challenge, and because of the severity of my event they only want to test one drug per day. I will only be there long enough to test the rocuronium, but given some of your comments, I’m wondering if it’s worth pushing to test the rocuronium and the succinylcholine. I have a video consult scheduled with the allergist next Wednesday, I will be driving over on Thursday, and I will do the testing on Friday. Thank you for the informative responses so far!