[Severe coronary events and corticoids bolus. An update apropos of 3 new cases]

The authors report two new cases of angina and/or myocardial infarction and one sudden death after an infusion of a bolus of high dose steroids. Coronary spasm, demonstrated in one of the cases and highly probable in the other two, is proposed as the mechanism of ischaemia. The authors underline the importance of the underlying pathology, previous coronary history, and the modes of administration. This type of treatment is often essential in clinical medicine and therefore the potentially severe secondary effects must be understood. Therefore, a previous history of myocardial infarction constitutes a definitive contra-indication and the duration of injection must be over one hour for doses greater than 250 mg. In all cases, a detailed medical history and an ECG are essential before starting treatment.