Corticosteroids - Induced Bradycardia : A Case Report & Literature Review

Sinus corticosteroids-induced bradycardia with high dose steroids has been reported in literature. Although the association is still not clearly understood but several mechanisms have been prompted to explain causality. The authors had a case of 54 years female who presented with slurred speech and confusion that was noted while she was at work. In the emergency department the patient was hypotensive and hypoglycemic with no response to intravenous fluids hydration and was diagnosed with adrenal insufficiency. sepsis, bleeding and allergic reaction were ruled out. Her blood pressure improved on steroid therapy but she developed profound bradycardia with heart rate of 20 beat per minutes (BPM). Steroids-induced bradycardia was suspected and the patient`s heart rate improved after tapering off the steroids without the need for atropine or pacemaker. In this paper we are reporting a case of sinus bradycardia caused by corticosteroids and reviewing literature that focus on the association between corticosteroids and bradycaria and their causes.