SEVERE CORONARY EVENTS AND STEROID BOLUS - AN UPDATE WITH RESPECT TO 3 NEW CASES

The authors report two new cases of angina and/or myocardial infarctio n and one sudden death after an infusion of a bolus of high dose stero ids. Coronary spasm, demonstrated in one of the cases and highly proba ble in the other two, is proposed as the mechanism of ischaemia. The a uthors underline the importance of the underlying pathology, previous coronary history, and the modes of administration. This type of treatm ent is often essential in clinical medicine and therefore the potentia lly severe secondary effects must be understood. Therefore, a previous history of myocardial infarction constitutes a definitive contra-indi cation and the duration of injection must be over one hour for doses g reater than 250 mg. In all cases, a detailed medical history and an EC G are essential before starting treatment.