If gene mutations are present, exposure to precipitating agents (anesthetic gases/succinylcholine) causes massive releases of Ca into the sarcoplasm causing prolonged muscle contraction and rigidity. This causes a hypermetabolic state resulting in increased O2 consumption, increased CO2 production, increased lactic acid production, ATP depletion and increased heat production. This leads to myocyte death (rhabdomyolysis) causing hyperkalemia and renal damage from myoglobin entering the blood. As a result respiratory/metabolic acidosis, hyperthermia, hypoxia, hypercapnia, hyperkalemia, and hypocalcemia, occur leading to ventricular dysrhythmias, multiple organ failures and death