A less recognized risk in patients on chronic glucocorticoid is cardiac arrhythmias, particularly atrial fibrillation and flutter. Also, in few cases sudden cardiac death is also reported. Interestingly, risk is higher in new users and long-term users but not for former users.
This risk is irrespective and independent of any underlying pulmonary or cardiac disease. This risk is higher with the use of diuretics as probable underlying cause is hypokalemia.
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#pharmacology
References:
1. van der Hooft CS, Heeringa J, Brusselle GG, et al. Corticosteroids and the risk of atrial fibrillation. Arch Intern Med 2006; 166:1016.
2. Christiansen CF, Christensen S, Mehnert F, et al. Glucocorticoid use and risk of atrial fibrillation or flutter: a population-based, case-control study. Arch Intern Med 2009; 169:1677.
3. White KP, Driscoll MS, Rothe MJ, Grant-Kels JM. Severe adverse cardiovascular effects of pulse steroid therapy: is continuous cardiac monitoring necessary? J Am Acad Dermatol 1994; 30:768.
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