Acute Symptomatic Sinus Bradycardia in High-Dose Methylprednisolone Therapy in a Woman With Inflammatory Myelitis: A Case Report and Review of the Literature

Sodero, Alessandro; Squitieri, Martina; Mazzeo, Salvatore; Pasca, Matteo; Matà, Sabrina; Pieri, Francesco; Bessi, Valentina; Sorbi, Sandro

doi:10.1177/1179547619831026

Cited by 12 publications

(6 citation statements)

References 21 publications

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“…A literature review revealed that steroid-induced bradycardia is likely underdiagnosed because most patients are asymptomatic,2 7 8 in contrast to our case where the patient experienced symptoms. Although the bradycardia resolves spontaneously after discontinuation of the medication, it is also crucial to rule out other, more prevalent causes of bradycardia, such as hypothyroidism, electrolyte imbalance and the use of drugs including beta-blockers, calcium channel blockers and digitalis.…”

Section: Discussioncontrasting

confidence: 68%

Hydrocortisone-induced symptomatic sinus bradycardia

et al. 2022

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Steroids are commonly prescribed medications that have a wide range of adverse effects. Bradycardia is one of the rare but significant side effects of steroid use, and only a few cases have been reported with bradycardia as a side effect. In this report, we present a case of a woman in her early 50s who developed severe symptomatic sinus bradycardia following high-dose administration of intravenous hydrocortisone, initiated for acute exacerbation of Crohn’s disease. Her symptoms entirely resolved after discontinuation of the steroid. This case highlights the importance of obtaining baseline ECG and cardiac monitoring in patients treated with pulsed high-dose steroids.

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Section: Discussioncontrasting

confidence: 68%

Hydrocortisone-induced symptomatic sinus bradycardia

et al. 2022

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“…Corticosteroids are among the agents that can cause bradycardia. 18 Direct corticosteroids on the myocardium, altered responses to catecholamines, and electrolyte shifts are among the proposed mechanisms underlying corticosteroids associated with bradycardia. 19 In our patients, corticosteroid was not discontinued.…”

Section: Discussionmentioning

confidence: 99%

Remdesivir-Associated Significant Bradycardia: A Report of Three Cases

Shirvani¹,

Sayad²,

Shojaei³

et al. 2021

JTHC

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Recently, remdesivir was approved by the United States Food and Drug Administration for patients with Coronavirus disease 2019 (COVID-19). We herein describe 3 patients with COVID-19 who showed significant bradycardia and QTc prolongation after remdesivir administration. Bradycardia did not respond to atropine treatment in 2 of the patients, one of whom received theophylline and the other required a temporary pacemaker. Fortunately, the patients’ heart rate and rhythm returned to normal after the discontinuation of remdesivir, albeit it lengthened their hospital stays. Careful monitoring during remdesivir infusion may decrease the risk of adverse cardiovascular side effects.

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“…High-dose intravenous prednisolone might cause acute sinus bradycardia 289 , 290 or, in MS patients, sinus tachycardia, bradycardia, and rarely AF and VT 289…”

Section: Treatment Of Sars-cov-2 Infectionmentioning

confidence: 99%

ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2—care pathways, treatment, and follow-up

Baigent¹,

Windecker²,

Andreini³

et al. 2021

European Heart Journal

132

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Aims Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular (CV) disease in association with COVID-19. Methods and results A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, which was reported previously, focused on the epidemiology, pathophysiology, and diagnosis of CV conditions that may be manifest in patients with COVID-19. This second part addresses the topics of: care pathways and triage systems and management and treatment pathways, both of the most commonly encountered CV conditions and of COVID-19; and information that may be considered useful to help patients with CV disease (CVD) to avoid exposure to COVID-19. Conclusion This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities.

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Acute Symptomatic Sinus Bradycardia in High-Dose Methylprednisolone Therapy in a Woman With Inflammatory Myelitis: A Case Report and Review of the Literature

Cited by 12 publications

References 21 publications

Hydrocortisone-induced symptomatic sinus bradycardia

Hydrocortisone-induced symptomatic sinus bradycardia

Remdesivir-Associated Significant Bradycardia: A Report of Three Cases

ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2—care pathways, treatment, and follow-up

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