Title : Hydrocortisone Induced Symptomatic Sinus Bradycardia
Abstract:
Doctors use corticosteroids in the treatment of various autoimmune and acute inflammatory conditions. More specifically, hydrocortisone is used in short-term high doses for remission induction in patients with moderate to severe flares of Crohn’s disease. This report describes a case of hydrocortisone-induced symptomatic sinus bradycardia, a rare side effect of high-dose steroids.
A 52-year-old female with background Crohn’s disease was admitted to the hospital with severe abdominal pain, bilious vomiting and mild abdominal distension. She was diagnosed with small bowel obstruction secondary to an acute flare of Crohn’s disease and treated with 100mg hydrocortisone four times daily, intravenous fluids and antiemetics. After three days of treatment, she developed palpitations, and her heart rate dropped to 28 beats per minute while other vitals remained stable. The patient was not on heart rate limiting medication, cardiovascular evaluation detected no abnormality, and she was monitored on Telemetry. We stopped her steroids, continued all other drugs, and her heart rate slowly improved over the next 24 hours without further intervention.
Clinicians need to be aware of corticosteroid-induced bradycardia, a rare, reversible and potentially life-threatening side effect of high-dose steroids. Therefore, we advocate for cardiac monitoring in patients who receive high doses steroids to enable early intervention in patients who develop such adverse effects.
What will audience learn from your presentation?
- Bradycardia is a rare side effect of high dose steroids.
- Steroid induced bradycardia is reversible.
- ECG or cardiac monitoring for patients receiving high dose steroids.
