Steroid therapy during acute myocardial infarction: A cause of delayed healing and of ventricular aneurysm

Abstract

Clinical and necropsy observations are described in a man who received large doses of corticosteroids for Dressler's syndrome which complicated acute myocardial infarction. Although the patient survived for 63 days, during 53 of which he received corticosteroids, the infarct histologically appeared to be only 10 to 14 days old. Thus, the healing of the infarct was clearly delayed. Experimental studies in dogs were cited in which healing of myocardial infarction was delayed by corticosteroid therapy. In our patient a large left ventricular aneurysm also developed. Study of previous reports of human subjects receiving corticosteroids during acute myocardial infarction disclosed that aneurysmal formation was also a common complication of corticosteroid therapy for the postmyocardial infarction syndrome. It is concluded that use of glucocorticosteroids for any reason during acute myocardial infarction may be hazardous, and that their use in patients with the postmyocardial infarction syndrome, a benign and self-limited condition, should be avoided.