A new article published in Archivos Argetinos de Pediatria presented a case of sinus bradycardia associated with stress-dose corticosteroid therapy in a nine-year-old boy. 

The child was admitted with gastroenteritis and pneumonia and developed septic shock on the day of admission. He had a history of panhypopituitarism.

The patient showed full recovery with intravenous fluids, stress doses of hydrocortisone and antibiotic therapy. However, within 24 hours following treatment, sinus bradycardia was documented – with a heart rate of 45 beats per minute (BPM). The bradycardia resolved after tapering the dose of hydrocortisone.

In summary, it was stated that corticosteroid-induced sinus bradycardia usually resolves after corticosteroid treatment is discontinued. Thus, during stress-dose corticosteroid therapy, hemodynamic monitoring is important. This was first report of sinus bradycardia with the use of hydrocortisone in children having adrenal insufficiency.

Source: Archivos Argetinos de Pediatria. 2021 Aug;119(4):e353-e356.