The Cardiovascular Effects of Corticosteroids

Abstract

Cardiovascular actions of corticosteroids and indications for their use in cardiovascular diseases are reviewed. Their acceleration of atrioventricular conduction has been put to practical use in the treatment of heart block. As anti-inflammatory agents, they control symptoms of pericarditis or myocarditis. Their use for the treatment of acute myocardial infarction is as yet experimental. Fluid retention produced by mineralocorticoid hormones leads to symptomatic improvement in patients with postural hypotension. Under special circumstances analogs of hydrocortisone provoke diuresis in patients with advanced heart failure. The adrenocortical hormones provide specific treatment when hypotension is due to adrenal insufficiency, a relatively rare cause of shock. When administered in very high doses for their pharmacologic effect in patients with septic shock, they improve survival. Their use is also indicated in treatment of protracted hypotension due to severe hypersensitivity reactions. As yet, there is inadequate evidence of beneficial effect in the management of shock caused by hemorrhage or trauma.