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Case Reports in Cardiology
Volume 2016 (2016), Article ID 9785467, 5 pages
Case Report

Bradycardia Associated with Steroid Use for Laryngeal Edema in an Adult: A Case Report and Literature Review

1Baltimore VA Medical Center, Baltimore, MD, USA
2Department of Surgery, University of Maryland Medical Center, Baltimore, MD, USA
3Baltimore VA Medical Center, Surgical Intensive Care Unit, 10 North Greene Street, 5C-119, Baltimore, MD 21201, USA
4University of Maryland Medical Center, 16 S. Eutaw, Suite 500, Baltimore MD 21201, USA

Received 9 August 2016; Accepted 31 October 2016

Academic Editor: Kathleen Ngu

Copyright © 2016 Preeti R. John et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Steroids are used for specific indications in the perioperative period to reduce laryngeal or spinal cord edema, or for prophylaxis and treatment of postoperative nausea and vomiting. Given the other potential causes for hemodynamic alterations in the perioperative setting, it is important for physicians to be aware of cardiovascular side effects of short term steroids. Changes in blood pressure and heart rate, cardiac dysrhythmias, and even death have been described in patients receiving short term intravenous steroids. Bradycardia has been reported following short term methylprednisolone and dexamethasone therapy in both adult and pediatric patients. There are only two case reports in the literature of bradycardia following short term intravenous dexamethasone use in adult patients. This is the first case report that describes bradycardia following the use of dexamethasone in the postoperative setting for management of laryngeal edema in an adult. Telemetry and twelve lead electrocardiograms revealed sinus bradycardia and correlated directly with administration of dexamethasone in our patient. Bradycardia resolved following discontinuation of dexamethasone. We advocate for hemodynamic monitoring in patients receiving more than one dose of intravenous steroid therapy in the perioperative period, especially those with known cardiac and hepatic comorbidities and those taking medications with negative chronotropic effects.