A 55-year-old male is in coronary care unit having
suffered an anterior myocardial infarction.
Three days after admission, he complains of a sharp,
substernal pain, which is relieved by leaning forward and aggravated by lying
down. The pain is also aggravated by movement and respiration. On examination
he is febrile and has a tachycardia and on auscultation of his chest a
pericardial friction rub is audible.
Your house physician has started the patient on NSAIDS in
high dosage and asks for your advice regarding the use of steroids on this
patient. You inform him that in this patient the use of steroids and NSAIDS:
Increases the risk of re-infarction
Increases the risk of pulmonary embolism
Increases the risk of myocardial rupture
Increases the risk of brady-arrhythmias
Increases the risk of tachy-arrhythmias