rhabdomyolysis question

Esme12, ASN, BSN, RN · Oct 17, 2012

If the Simvistatin is causing his rhabdo......they would have stopped the med. Why is this patient in LTC? What are the patient s co-mobidities? If the rhabdo is old there has to be another cause.......rhabdo is an acute process not chronic without the presence of degenerative inflammatory muscle disorders.....

.Medscape: Medscape Access requires registration but it is free and an EXCELLENT source of information/resources/sources

Rhabdomyolysis (literally, “dissolution of skeletal muscle”) is a syndrome caused by injury to skeletal muscle and involves leakage of large quantities of potentially toxic intracellular contents into plasma.A preliminary diagnosis of rhabdomyolysis requires a high index of suspicion. A definitive diagnosis is achieved by means of laboratory evaluation. Trauma and muscle compression are believed to cause rhabdomyolysis through direct injury to muscles.Occlusion of muscular vessels due to thromboemboli, traumatic injury, or surgical clamping may lead to rhabdomyolysis if muscle tissue ischemia is prolonged.

Orthopedic trauma, including compartment syndromes and fractures, may result in rhabdomyolysis. Such trauma commonly occurs in traffic and occupational accidents. Orthopedic injuries in natural disasters (eg, earthquakes) are compounded by immobilization, hypovolemia, and significant rates of rhabdomyolysis. Medscape: Medscape Access

In addition to the conditions listed in the differential diagnosis, other problems to be considered include the following:

Traumatic injuries (including nonaccidental abuse in children)
Viral infections
Myalgias from other etiologies
Bacterial infections
Cold exposure
Malignant hyperthermia
Muscle phosphorylase deficiency
Phosphofructokinase deficiency
Carnitine palmityl transferase deficiency
Phosphoglycerate mutase deficiency
Hyperosmotic conditions
Guillain-Barré syndrome
Inflammatory myositis

aachavez · Oct 18, 2012

It's a bummer that I don't really have more info on this patient, I am curious about how his situation came about. However, it seems like it was a couple years ago, so there's no way to find out how it happened, and essentially this patient's case just led me to a general question. I came across some info in a chart, and it just made me curious about the disease process in general, not as it relates to this patient.

I just didn't make the connection that a clot could cause muscle tissue death leading to rhabdo, but it's interesting, will be doing some more reading on this for sure.

Esme12, ASN, BSN, RN · Oct 18, 2012

Also if they have ever fallen and fracture their hip......and they laid there for a while would cause Rhabdo......anything that cuts off blood flow to the muscle, causes muscle damage , and causes a sever increase in the CPK is at risk for Rhabdo.

jjamesrn · Jul 13, 2016

I know this is a late response to the original question, but I thought it should be clarified. Rhabdomyolysis is a muscle breakdown or muscle death with numerous etiologies. So, think about why a DVT could cause rhabdo? What happens with a DVT? Swelling...pain. Could it be possible, that the swelling is causing a lack of blood supply to a certain area of muscle tissue? Sure! Let's say the client had this for a while without getting treatment...this could cause further breakdown of muscle tissue depending on how large the DVT is and where it is located. In addition, let's assume that the client stayed at home for a while prior to being admitted to the hospital....could s/he have been in pain and might have restricted movement causing a breakdown of muscle as well. So, think about what is rhabdo and use what you know about DVT to come up with an answer...it's really kind of fun! You're like a NCIS agent for healthcare:)