In myasthenia gravis, which complication can be life-threatening due to weakness of respiratory muscles?

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In myasthenia gravis, muscles that are used repeatedly – including the diaphragm and intercostal muscles that drive breathing – can become fatigued and weak. When respiratory muscles are sufficiently compromised, ventilation cannot meet the body's needs, leading to respiratory failure. This situation, known as a myasthenic crisis, is life-threatening if not promptly managed with airway support and treatment aimed at improving neuromuscular transmission (such as plasma exchange or IVIG, along with acetylcholinesterase inhibitors and other supportive care). Watch for increasing shortness of breath, shallow rapid breathing, poor airway clearance, and rising carbon dioxide levels that signal impending respiratory failure. Other options like seizures, myocardial infarction, or portal hypertension do not result from weakness of respiratory muscles in MG.