First report of supraventricular tachycardia after intravenous pulse methylprednisolone therapy, with a brief review of the literature
First report of supraventricular tachycardia after intravenous pulse methylprednisolone therapy, with a brief review of the literature
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甲泼尼龙静脉冲击治疗后室上性心动过速的首次报告，并简要回顾文献
DOI：
10.1007/s00296-005-0589-7
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发表时间：
2005
影响因子：
4
通讯作者：
S. Uppal
中科院分区：
文献类型：
--
作者：
R. Kumari;S. Uppal
本文首次报道了一例活动性类风湿关节炎患者接受大剂量甲基强的松龙静脉冲击治疗（HIVMPT）后发生室上性心动过速。本病例报告进一步扩大了HIVMPT可能发生的心律失常的范围。先前报道的HIVMPT后发生的其他心律失常包括心房颤动、心房扑动、交界性心律和室性心动过速。据我们所知，室上性心动过速以前没有报告，虽然严重心动过缓，低血压，心搏停止，心血管崩溃，猝死已被记录。文献综述表明，尽管这些病例报告，HIVMPT通常是安全的，心血管毒性是罕见的。然而，在HIVMPT期间和之后立即进行血压，心电图和血液电解质的重复测量的密切监督是强制性的，特别是对于预先存在心血管疾病的患者，并且应以缓慢的速度输注最低有效剂量的甲基强的松龙。
The occurrence of supraventricular tachycardia after high-dose intravenous methylprednisolone pulse therapy (HIVMPT) in a patient with active rheumatoid arthritis is described for the first time. This case report further expands the range of arrhythmias that can occur with HIVMPT. Other arrhythmias previously reported to occur after HIVMPT include atrial fibrillation, atrial flutter, junctional rhythm, and ventricular tachycardia. To the best of our knowledge, supraventricular tachycardia has not been reported previously, although severe bradycardia, hypotension, asystole, cardiovascular collapse, and sudden death have been documented. A review of the literature indicates that these case reports not withstanding, HIVMPT is generally safe, and cardiovascular toxicity is rare. However, close supervision with repeated measurements of blood pressure, electrocardiogram, and blood electrolytes is mandatory during and immediately after HIVMPT, especially for patients with pre-existing cardiovascular disease, and the lowest effective dose of methylprednisolone should be infused at a slow rate.